目的:探讨腹腔镜手术对肾癌患者血清血管紧张素(Ang)、血管内皮生长因子(VEGF)及T细胞亚群的影响.方法:选取本院手术治疗的90例肾癌患者,其中行后腹腔镜手术者45例为观察组,行常规开放手术治疗者45例为对照组.比较两组手术情况及术后恢复情况,观察两组手术前后血清Ang、VEGF及T细胞亚群水平差异.结果:观察组术中出血量、术后卧床时间及住院时间均显著小于对照组(P<0.05),而两组手术时间比较,差异无显著性(P>0.05).观察组术后1 d和术后5 d血清Ang-1、Ang-2、VEGF水平均显著降低,且低于同期对照组,差异具有显著性(P<0.05).观察组术后1 d和术后5 d患者血CD3+、CD4+及CD4+/CD8+均明显高于对照组,差异具有显著性(P<0.05).结论:与常规开放手术相比,后腹腔镜手术具有出血少、恢复快等优点,且能够明显降低血清Ang、VEGF水平及减小对机体免疫功能的影响,有利于患者的恢复.
Objective:To investigate the influence of retroperitoneal laparoscopic operation for serum angiotension (Ang),vascular endothelial growth factor (VEGF)and T - lymphocyte subset in patients with renal carcinoma. Methods:90 patients with renal carcinoma were enrolled in this study. 45 patients in observation group were treated by retroperitoneal laparoscopic operation and 45 patients in control group were treated by open radical nephrectomy. The general situations of operation and recovery were compared. The differences of serum Ang,VEGF and T - lympho-cyte subset in two groups were observed. Results:The blood loss,time in bed and hospital stay of observation group were significantly less than those of control group (P < 0. 05). There were no significant differences in time of operation between two groups (P > 0. 05). The levels of serum Ang - 1,Ang - 2,VEGF in observation were signifi-cantly less,1 day and 5 day after operation,and were significantly lower than the same period in control group (P < 0. 05). The levels of CD3 +,CD4 + and CD4 + / CD8 + in observation group 1 day and 5 day after operation were significantly higher than those in control group (P < 0. 05). Conclusion:Compared with open radical nephrectomy, retroperitoneal laparoscopic operation has the advantages of less bleeding,rapid recovery. It can significantly reduce serum Ang,VEGF levels and decrease the effect on immune function and also be beneficial to recovery.