首页|腹腔镜与开腹治疗胆囊癌:一项随机对照研究

腹腔镜与开腹治疗胆囊癌:一项随机对照研究

扫码查看
目的:探讨不同的手术治疗方式对胆囊癌术后疗效及血清炎症因子、T淋巴细胞亚群水平的影响.方法:选择2020年1月—2023年3月西安交通大学第一附属医院收治的胆囊癌患者96例,按照随机数字表法分成对照组和研究组,每组48例,对照组采用开腹胆囊癌根治术,研究组采用腹腔镜胆囊癌根治术,比较两组术前和术后7 d血清炎症因子[白细胞介素(IL)-6、IL-8、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]水平、T淋巴细胞亚群(CD3+、CD4+、CD8+)水平、围手术期相关指标(肠功能恢复时间、手术时间、术中出血量、住院时间)、并发症发生率及复发率和死亡率.结果:术前,两组IL-6、IL-8、CRP、TNF-α水平差异无统计学意义(P>0.05);与术前相比,术后7 d两组IL-6、IL-8、CRP、TNF-α水平均升高,且研究组低于对照组,差异有统计学意义(P<0.05).术前,两组CD3+、CD4+、CD8+差异无统计学意义(P>0.05);与术前相比,两组术后7 d的CD3+、CD4+、CD8+水平均降低,且研究组高于对照组,差异有统计学意义(P<0.05);研究组肠功能恢复时间、手术时间、术中出血量、住院时间均少于对照组(P<0.05).研究组术后并发症发生率低于对照组(2.08%比14.58%),差异有统计学意义(P<0.05).两组术后1年内的复发率及死亡率差异无统计学意义(P>0.05).结论:腹腔镜胆囊癌根治术可明显改善胆囊癌患者炎症因子水平,降低术后并发症发生的风险,且安全性高.
Laparoscopic and open surgery for gallbladder cancer:a randomized controlled study
Objective:To explore the effects of different surgical treatment methods on postoperative efficacy,serum inflammatory factors,and T lymphocyte subsets levels in patients with gallbladder cancer. Methods:96 patients with gallbladder cancer admitted to the First Affili-ated Hospital of Xi'an Jiaotong University from January 2020 to March 2023 were randomly divided into a control group and a study group,with 48 patients in each group. The control group under-went open cholecystectomy,while the study group underwent laparoscopic cholecystectomy. The levels of serum inflammatory factors (IL-6,IL-8,CRP,TNF-α),T lymphocyte subsets (CD3+,CD4+,CD8+),perioperative indicators (intestinal function recovery time,surgery time,intraoperative bleeding,hospital stay),incidence of complications,recurrence rate,and mortality rate were com-pared between the two groups before and 7 days after surgery. Results:Before surgery,there was no statistically significant difference in the levels of IL-6,IL-8,CRP,and TNF-α between the two groups(P>0.05);Compared with preoperative levels,the levels of IL-6,IL-8,CRP,and TNF-α in both groups increased 7 days after surgery,and the study group was lower than the control group,with statistical significance(P<0.05). Before surgery,there was no statistically significant difference in CD3+,CD4+,and CD8+between the two groups(P>0.05);Compared with preopera-tive levels,the levels of CD3+,CD4+,and CD8+in both groups decreased 7 days after surgery,and the study group was higher than the control group,with statistical significance(P<0.05);The re-covery time of intestinal function,surgical time,intraoperative blood loss,and hospital stay in the study group were all shorter than those in the control group(P<0.05). The incidence of postopera-tive complications in the study group was lower than that in the control group (2.08% vs 14.58%),and the difference was statistically significant(P<0.05). There was no statistically significant differ-ence in recurrence and mortality rates between the two groups within one year after surgery(P>0.05).Conclusion:Laparoscopic radical cholecystectomy can significantly improve the levels of inflammatory factors in patients with gallbladder cancer,reduce the risk of postoperative complica-tions,and has high safety.

Laparoscopic surgeryGallbladderSerum inflammatory factorT lymphocyte subsetsRecurrence rateMortality

谭文君、邢斌瑜、朱皓阳、俞兆坤、李希、王文静

展开 >

西安交通大学第一附属医院 外科重症医学科,陕西 西安 710061

西安交通大学第一附属医院 麻醉科,陕西 西安 710061

腹腔镜手术 胆囊癌 血清炎症因子 T淋巴细胞亚群 复发率 死亡率

2024

中国现代普通外科进展
山东大学

中国现代普通外科进展

CSTPCD
影响因子:0.993
ISSN:1009-9905
年,卷(期):2024.27(11)