[1]张成学.腹腔镜根治术对宫颈癌患者免疫功能的影响研究[J].中国计划生育和妇产科,2018,(7):22-27.
　ZHANG Cheng-xue.Effect of laparoscopic radical surgery on immune function in patients with cervical cancer[J].Chinese Journal of Family Planning & Gynecotokology,2018,(7):22-27.
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腹腔镜根治术对宫颈癌患者免疫功能的影响研究
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2018年7期
页码:
22-27
栏目:
论著与临床
出版日期:
2018-07-25

文章信息/Info

Title:
Effect of laparoscopic radical surgery on immune function in patients with cervical cancer
作者:
张成学
苍溪县人民医院妇产科
Author(s):
ZHANG Cheng-xue
Department of Obstetrics and Gynecology，Cangxi County People's Hospital， Cangxi Sichuan 628400，P.R.China
关键词:
腹腔镜手术; 开腹手术; 宫颈癌根治术; 临床疗效; 免疫功能
Keywords:
laparoscopic surgery;  abdominal surgery;  cervical cancer radical operation;  clinical effect;  immunity
分类号:
R 73733
摘要:
目的比较并探讨腹腔镜根治术（laparoscopic radical surgery，LRS）与传统开腹手术（abdominal radical surgery，ARS）治疗宫颈癌（cervical cancer,CC）的临床疗效、安全性以及对机体免疫功能的影响。方法回顾性分析2012年3月至2017年2月在苍溪县人民医院行CC根治术的421例患者的临床资料，其中81例行腹腔镜手术（LRS组），340例行传统开腹手术（ARS组），比较两组患者术中、术后近期疗效、安全性以及对干扰素γ（interferon-γ，IFN-γ）、肿瘤坏死因子α（tumor necrosis factor-α，TNF-α）、白介素2（interleukin-2，IL-2）、IL-6、IL-4、IL-10等细胞因子的影响。结果两组患者淋巴结清扫个数基本一致（P>005）,但LRC组手术时间［（26924±5786）min］长于ARS组［（23579±4941）min］（P<005）；LRC组患者术中失血量［（18067±5042）mL vs （37985±12646）mL］、输血率［247 % vs 1912 %］、术后住院时间［（866±251）d vs （1135±426）d］，胃肠功能恢复时间［（248±076）d vs (339±115) d］、术后感染或渗血率（247 % vs 1029 %）和副损伤率（0 vs 559 %）均低于ARS组，差异有统计学意义（P<005）。术后1 d，LRS组患者IL-6含量较术前1 d升高，而ARS组患者IFN-γ、TNF-α、IL-2、IL-6的含量与术前1 d比较，差异均有统计学意义（P<005）；同时两组TNF-α、IL-2、IL-6的含量比较，差异有统计学意义（P<005）。ARS组患者术后1 d外周血中Th 1/Th 2比值较术前1 d有所下降（P<005），术后28 d两组患者外周血中Th 1/Th 2比值较术前1 d都有所升高（P<005）；但两组间比较，差异无统计学意义（P>005）。结论腹腔镜CC根治术具有疗效显著、术后恢复快、不良反应发生率低、对机体免疫功能干扰小并且远期改善患者免疫状态等优势，值得临床推广
Abstract:
ObjectiveTo compare and explore the clinical efficacy, safety and impact on immune function of laparoscopic radical surgery（LRS） and traditional abdominal radical surgery（ARS） in treating cervical cancer (CC). MethodsA total of 421 patients undergoing cervical cancer radical surgery at Cangxi County People's Hospital from March 2012 to February 2017 were retrospectively analyzed. Among them, 81 patients underwent laparoscopic surgery (LRS group) and 340 patients underwent conventional laparotomy (ARS group). The short-term efficacy and safety during and after surgery, impact on interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin 2 (IL-2), IL-6, IL-10 and other cytokines between the LRS group and ARS group were compared. ResultsThe number of lymph node dissection in two groups was basically the same (P> 005). However, the operative time in LRC group［(26924 ± 5786)min］ was longer than that in ARS group ［(23579 ± 4941) min)］.The blood loss in the LRC group［(18067 ± 5042) mL vs (37985 ± 12646)mL］, blood transfusion rate (247% vs 1912%), postoperative hospital stay ［(866 ± 251) d vs (1135 ± 426) d］, gastrointestinal function recovery time ［(248 ± 076) d vs (339 ± 115) d］, postoperative infection or bleeding rate (247 % vs 1029 %) and accessory injury rate（0 vs 559 %） were lower than those in ARS group, the differences were statistically significant (P<005).1 day after surgery, the serum value of IL-6 in LRS group were higher(P<005); however, the levels of IFN-γ, TNF-α, IL-2 and IL-6 in ARS group were significantly different from those in the first day before operation (P<005). At the same time, the differences of TNF-α, IL-2 and IL-6 in the two groups were also statistically significant (P<005). In the ARS group, the Th 1 / Th 2 ratio in the peripheral blood decreased 1 day after operation (P<005), and the Th 1 / Th 2 ratio in the peripheral blood in both groups increased significantly than that of the preoperative 1 day (P <005). However, there was no significant difference between the two groups (P>005).ConclusionLaparoscopic cervical cancer radical surgery has the advantages of significant curative effect, rapid postoperative recovery, low incidence of adverse reactions, little interference on the immune function and long-term improvement of immune status in patients. It is worthy of clinical promotion.

参考文献/References:

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更新日期/Last Update: 2018-07-25