中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2013年
7期
529-533
,共5页
姜立新%胡金晨%荆鹏程%郑海涛%吕忠船%孙华君%郭吉田%张翼飞%陈红兵
薑立新%鬍金晨%荊鵬程%鄭海濤%呂忠船%孫華君%郭吉田%張翼飛%陳紅兵
강립신%호금신%형붕정%정해도%려충선%손화군%곽길전%장익비%진홍병
胃肿瘤%腹腔镜%C反应蛋白质%体液免疫%加速康复外科
胃腫瘤%腹腔鏡%C反應蛋白質%體液免疫%加速康複外科
위종류%복강경%C반응단백질%체액면역%가속강복외과
Stomach neoplasmas%Laparoscopes%C-reactive proteins%Humoral immune%Fast track surgery
目的 观察加速康复外科(fast track surgery,FTS)概念指导下腹腔镜辅助远端胃癌根治术(laparoscopy assisted distal gastrectomy,LADG)对胃癌患者炎症应激反应和体液免疫功能的影响.方法 选择烟台毓璜顶医院2009年1月至2010年11月期间入院接受手术治疗的82例远端胃癌患者,随机分为4组:FTS+ LADG组(19例)、LADG组(22例)、FTS+开腹远端胃癌根治术(open distalgastrectomy,ODG)组(21例)和ODG组(20例),检测4组患者的血清CRP、C3、CA、IgG、IgA、IgM并进行对比分析.结果 ODG组血清CRP术后水平和变化幅度明显高于其他3组(均P＜0.01、均P＜0.05),其中FTS+ LADG组在术后变化幅度低于FTS+ ODG组(均P＜0.05).FTS+ LADG组血清C3、CA水平高于ODG组(P ＜0.05、P＜0.05).血清C3水平变化幅度在其他3组明显低于ODG组(均P ＜0.05).血清C4水平变化幅度以FTS+ LADG组最低(P＜0.05),其次为LADG组(P＜0.01),ODG组最高(P＜0.05).术后其他3组血清IgG、IgA水平均高于ODG组(均P＜0.01).FTS+ LADG组的血清IgM水平变化幅度在第1～4天低于ODG组(P＜0.01).结论 FTS的围手术期处理和腹腔镜技术均可以减轻围手术期炎症应激反应,二者联合应用有一定的优势.
目的 觀察加速康複外科(fast track surgery,FTS)概唸指導下腹腔鏡輔助遠耑胃癌根治術(laparoscopy assisted distal gastrectomy,LADG)對胃癌患者炎癥應激反應和體液免疫功能的影響.方法 選擇煙檯毓璜頂醫院2009年1月至2010年11月期間入院接受手術治療的82例遠耑胃癌患者,隨機分為4組:FTS+ LADG組(19例)、LADG組(22例)、FTS+開腹遠耑胃癌根治術(open distalgastrectomy,ODG)組(21例)和ODG組(20例),檢測4組患者的血清CRP、C3、CA、IgG、IgA、IgM併進行對比分析.結果 ODG組血清CRP術後水平和變化幅度明顯高于其他3組(均P＜0.01、均P＜0.05),其中FTS+ LADG組在術後變化幅度低于FTS+ ODG組(均P＜0.05).FTS+ LADG組血清C3、CA水平高于ODG組(P ＜0.05、P＜0.05).血清C3水平變化幅度在其他3組明顯低于ODG組(均P ＜0.05).血清C4水平變化幅度以FTS+ LADG組最低(P＜0.05),其次為LADG組(P＜0.01),ODG組最高(P＜0.05).術後其他3組血清IgG、IgA水平均高于ODG組(均P＜0.01).FTS+ LADG組的血清IgM水平變化幅度在第1～4天低于ODG組(P＜0.01).結論 FTS的圍手術期處理和腹腔鏡技術均可以減輕圍手術期炎癥應激反應,二者聯閤應用有一定的優勢.
목적 관찰가속강복외과(fast track surgery,FTS)개념지도하복강경보조원단위암근치술(laparoscopy assisted distal gastrectomy,LADG)대위암환자염증응격반응화체액면역공능적영향.방법 선택연태육황정의원2009년1월지2010년11월기간입원접수수술치료적82례원단위암환자,수궤분위4조:FTS+ LADG조(19례)、LADG조(22례)、FTS+개복원단위암근치술(open distalgastrectomy,ODG)조(21례)화ODG조(20례),검측4조환자적혈청CRP、C3、CA、IgG、IgA、IgM병진행대비분석.결과 ODG조혈청CRP술후수평화변화폭도명현고우기타3조(균P＜0.01、균P＜0.05),기중FTS+ LADG조재술후변화폭도저우FTS+ ODG조(균P＜0.05).FTS+ LADG조혈청C3、CA수평고우ODG조(P ＜0.05、P＜0.05).혈청C3수평변화폭도재기타3조명현저우ODG조(균P ＜0.05).혈청C4수평변화폭도이FTS+ LADG조최저(P＜0.05),기차위LADG조(P＜0.01),ODG조최고(P＜0.05).술후기타3조혈청IgG、IgA수평균고우ODG조(균P＜0.01).FTS+ LADG조적혈청IgM수평변화폭도재제1～4천저우ODG조(P＜0.01).결론 FTS적위수술기처리화복강경기술균가이감경위수술기염증응격반응,이자연합응용유일정적우세.
Objective To observe the effect on humoral immune function and stress reaction of fast track surgery (FTS) combined with laparoscopy assisted distal gastrectomy (LADG) for gastric cancer patients.Methods Eighty-two patients were admitted to Yantai Yuhuangding Hospital with distal gastric cancer from January 2009 to November 2010,patients were randomly divided into four groups:(1) FTS + LADG (n =19),(2) LADG (n =22),(3) FTS + open distal gastrectomy (ODG) (n =21) and (4) ODG (n =20).CRP,C3,C4,IgG,IgA,IgM were determined and compared between the 4 groups.Results CRP levels was the highest in ODG group among the 4 groups after surgery (all P ＜ 0.01).That in FTS + LADG group changed less than that in FTS + ODG group (P ＜ 0.05).The levels of C3 and C4 were the highest in FTS + LADG group (P ＜ 0.05).C3 changed most drastically in ODG group (P ＜ 0.05).CA was the lowest in FTS + LADG group secondary in order to that in FTS + LADG group,FTS + ODG group and ODG group (P ＜0.05; P ＜0.01,P ＜0.01).IgG and IgA levels was the lowest in ODG group (all P ＜0.01).IgM changed less in FTS + LADG group than in ODG group (P ＜ 0.01).Conclusions FTS management and laparoscopic surgery can both decrease the inflammatory response and preserve the postoperative early humoral immune function.Combination of FIS and LADG contributes further though not statistically significant in reducing postoperative immune responses.
