CAJ | 학술논문

目的：比较进展期胃癌根治术中腹腔镜与开腹手术两种术式对患者免疫功能的影响。方法对2012年6月至2013年4月兰州军区兰州总医院及兰州大学第一医院收治的100例进展期胃癌患者随机分为两组，A组(腹腔镜手术组)和B组(开腹手术组)，每组各50例，比较两组术后免疫功能的变化及术中术后情况。结果两组患者均手术成功，无围手术期死亡病例，术后免疫检测显示(C3、C4、IgG、IgA、IgM)，第24、72小时免疫指标变化较术前均有明显抑制，第72小时后逐渐恢复，但腹腔镜组术后变化平缓，较术前差异无统计学意义，开腹组术后免疫功能受到明显抑制。术后各时间节点两组患者CRP均升高，但开腹组升高更明显，与腹腔镜组比较，差异具有统计学意义。结论腹腔镜进展期胃癌根治术对患者术后免疫功能影响小，机体损伤小。
목적：비교진전기위암근치술중복강경여개복수술량충술식대환자면역공능적영향。방법대2012년6월지2013년4월란주군구란주총의원급란주대학제일의원수치적100례진전기위암환자수궤분위량조，A조(복강경수술조)화B조(개복수술조)，매조각50례，비교량조술후면역공능적변화급술중술후정황。결과량조환자균수술성공，무위수술기사망병례，술후면역검측현시(C3、C4、IgG、IgA、IgM)，제24、72소시면역지표변화교술전균유명현억제，제72소시후축점회복，단복강경조술후변화평완，교술전차이무통계학의의，개복조술후면역공능수도명현억제。술후각시간절점량조환자CRP균승고，단개복조승고경명현，여복강경조비교，차이구유통계학의의。결론복강경진전기위암근치술대환자술후면역공능영향소，궤체손상소。
Objective To compare the influence of laparoscopic radical-resection and laparotomy on im-mune function in patients with advanced gastric cancer. Methods One hundred patients with advanced gastric can-cer from June 2012 to April 2013 in General Hospital of Lanzhou Command of PLA and the First Affiliated Hospital of Lanzhou University were randomly divided into group A (laparoscope group) and group B (laparotomy group). There were 50 patients in each group. The postoperative changes of immune function between these two groups were compared. Results Operations of patients in both groups were successful and there was no perioperative death case. Our data showed that the levels of C3, C4, IgG, IgA and IgM in blood were significantly inhabited 24 and 72 hours after operation. After 72 hours, the immune function gradually recovered. In laparoscope group, the immune function changed smoothly after operation and there was no statistical significance before and after the operation. The immune function was significantly inhabited in group B after operation. The levels of CRP of patients in two groups increased after surgery at different time points. Notably, we found that the increase of CRP level in group B was statis-ticaly significantly higher than that in group A. Conclusion Laparoscopic radical-resection has lower effect on im-mune function and lower body damage for patients with advanced gastric cancer.