目的:探讨腹腔镜结直肠癌根治术对患者免疫状态和CRP的影响。方法:选择我院收治的90例行手术治疗的结直肠癌患者,随机将其分为观察组和对照组各45例,观察组给予腹腔镜手术,对照组给予开放手术治疗,对比两组术前、术后3 d及术后7 d各免疫指标和CRP变化情况。结果:观察组术后3 d及术后7 d时CRP指标较治疗前显著上升,差异均有统计学意义(P<0.05)；且观察组术后7 d CRP显著低于同时间段对照组,差异有统计学意义(P<0.05)；对照组术后3 d时IgM及IgG水平较术前及观察组术后3 d显著下降,比较差异有显著性(P<0.05)；对照组术后3 d时CD4⁺和CD8⁺指标水平及术后7 d时CD8⁺指标水平较术前1 d时显著下降,亦显著低于同时间段观察组指标水平,差异均有统计学意义(P<0.05)。结论:腹腔镜术式较开放术式而言对患者免疫功能的影响较小,炎症应激损伤小,值得临床推广应用。

Objective: To investigate the effect of laparoscopic radical resection of colorectal cancer on the immune status and CRP. Methods: A total of 90 patients with colorectal cancer treated in our hospital from January 2017 to June 2017 were randomly divided into the observation group and the control group, each with 45 cases. The observation group received laparoscopic surgery, while the control group was given open surgery. The changes of immune indexes and CRP in two groups before and after 3d and after 7d were compared. Results: ①In the control group, the postoperative 3d and postoperative 7d, CRP index were (7.87±2.01) mg/dl, (2.81±1.03) mg/dl, the observation group postoperative 3d and postoperative 7d, CRP index were (7.01±1.33) mg/dl, (1.59±0.81) mg/dl, compared with before treatment, the difference was statistically significant (P<0.05). The CRP in the observation group postoperative 7d were significantly lower than those in the control group at the same time period, the difference was significant (P<0.05). The IgM and IgG index level of control group postoperative 3d respectively (137.04±23.46) IU/ml and (114.36±27.18) IU/ml, compared with preoperative and observation group postoperative 3d index level (163.07±30.19) IU/ml, (130.24±31.16) IU/ml decreased significantly, the difference was significant (P<0.05). ②The control group postoperative 3d CD4⁺ and CD8⁺ index level were respectively (0.49±0.05) * 10⁹/L ,(0.29±0.08) * 10⁹/L.CD8⁺ index level of 7d after operation was (0.31±0.10) * 10⁹/L, which were significantly decreased than 1d before operation and significantly lower than the same period of observation group indicator level (0.59±0.09) * 10⁹/L, (0.35±0.11) * 10⁹/L, (0.37±0.12) * 10⁹/L, the differences were statistically significant (P<0.05). Conclusion: Compared with open surgery, laparoscopic surgery has less influence on the immune function of patients, and has less inflammatory and stress damage, so it is worthy of clinical application.

R735.3+7

荆州医院支助项目(CXD201102)；湖北省卫计委科研项目(WJ2016-Y-20)