CAJ | 학술논문

目的：比较手辅助腹腔镜与传统腹腔镜右半结肠切除术对机体免疫功能的影响。方法前瞻性入组2010年5月至2013年11月间潍坊市人民医院收治的60例右半结肠癌手术患者，按随机数字表法分为手辅助组和腹腔镜组，每组30例。分别于术前1 d及术后1、3、5 d抽取患者外周静脉血，测定非特异性免疫指标C反应蛋白（CRP）和白介素6（IL-6）水平，以及细胞免疫指标CD3＋、CD4＋和CD8＋细胞数量。结果两组患者术前CRP、IL-6、CD3＋、CD4＋和CD8＋细胞的差异均无统计学意义（P＞0．05）。术后1、3和5 d，两组患者CRP和IL-6水平均较术前显著升高（P＜0．05），但两组间差异无统计学意义（P＞0．05）。术后1 d，两组患者CD3＋、CD4＋和CD8＋细胞均出现明显下降（P＜0．05）；术后3 d，CD8＋细胞恢复至术前水平（P＞0．05）；术后5 d，CD3＋和CD4＋细胞亦恢复至术前水平（P＞0．05）；术后各个时间点，两组间CD3＋、CD4＋和CD8＋细胞数量的差异均无统计学意义（P＞0．05）。结论手辅助腹腔镜与传统腹腔镜辅助右半结肠切除术在缓解术后应激及免疫功能保护方面具有同等优势。
목적：비교수보조복강경여전통복강경우반결장절제술대궤체면역공능적영향。방법전첨성입조2010년5월지2013년11월간유방시인민의원수치적60례우반결장암수술환자，안수궤수자표법분위수보조조화복강경조，매조30례。분별우술전1 d급술후1、3、5 d추취환자외주정맥혈，측정비특이성면역지표C반응단백（CRP）화백개소6（IL-6）수평，이급세포면역지표CD3＋、CD4＋화CD8＋세포수량。결과량조환자술전CRP、IL-6、CD3＋、CD4＋화CD8＋세포적차이균무통계학의의（P＞0．05）。술후1、3화5 d，량조환자CRP화IL-6수평균교술전현저승고（P＜0．05），단량조간차이무통계학의의（P＞0．05）。술후1 d，량조환자CD3＋、CD4＋화CD8＋세포균출현명현하강（P＜0．05）；술후3 d，CD8＋세포회복지술전수평（P＞0．05）；술후5 d，CD3＋화CD4＋세포역회복지술전수평（P＞0．05）；술후각개시간점，량조간CD3＋、CD4＋화CD8＋세포수량적차이균무통계학의의（P＞0．05）。결론수보조복강경여전통복강경보조우반결장절제술재완해술후응격급면역공능보호방면구유동등우세。
Objective To compare the effects of hand-assisted laparoscopic and traditional laparoscopic right hemicolectomy on immune function. Methods From May 2010 to November 2013, 60 patients with right colon carcinoma were prospectively enrolled and randomly divided into hand-assisted laparoscopic surgery(HALS) group and traditional laparoscopic surgery(TLS) group with 30 cases in each group. CRP, IL-6, CD3+, CD4+, CD8+ in the peripheral blood were measured and compared on the first day before operation, the first, third and fifth day after operation. Results CRP and IL-6 levels in two groups were significantly increased on the first, third and fifth days (P<0.01), and peaked on the third day after operation. Postoperative CRP and IL-6 levels were slightly higher in HALS group, but the difference was not statistically significant (P>0.05). CD3+and CD4+levels were significantly decreased on the first, third day after operation (P<0.05), and returned to preoperative levels on the fifth day after operation in both two groups , and the difference was not statistically significant (P>0.05). There was no significant difference in CD8+ between two groups either before surgery or after operation (P>0.05). Conclusion Hand-assisted laparoscopic right hemicolectomy has the same effects of traditional laparoscopic right hemicolectomy in the relief of postoperative stress and the protection of immune function.