腹腔镜与开腹肝切除术对单核细胞HLA-DR表达和细胞免疫功能影响的比较
发布时间：2018-12-28 11:20
【摘要】：目的通过分析单核细胞HLA-DR表达和体外刺激下细胞因子的分泌来比较开腹手术和腹腔镜手术术后免疫抑制情况。方法将2012年1月-2013年12月内收治的50例行肝切除患者,随机分为LH组和OH组,比较两组手术前后部分肝功能指标、平均切口长度、手术时间、麻醉时间及术中出血量的变化。流式细胞仪检测和比较两组患者单核细胞HLA-DR的表达特征,ELISA检测和比较脂多糖刺激后细胞中TNF-α、INF-γ、IL-6及IL-8等炎症因子的含量。结果两组术后ALT和AST迅速升高,与术前相比差异显著,而且OH组明显高于LH组。切口长度和出血量LH组明显小于OH组(P0.1);LH组手术时间、麻醉时间长于OH组,但差异无显著性(P0.05)。LH组中未出现术后免疫麻痹现象。术后第1天LH组II类主要组织相容性复合物升高,而开腹手术组II类主要组织相容性复合物下降。OH组患者术后TNF-α、IL-6和IFN-γ的分泌低于LH组。结论在行开腹或腹腔镜肝切除术患者中均未发现免疫麻痹现象,但是腹腔镜组患者在肝切除后免疫功能恢复情况较好。
[Abstract]:Objective to compare the immunosuppression between open surgery and laparoscopic surgery by analyzing the expression of monocyte HLA-DR and cytokine secretion stimulated by in vitro. Methods Fifty patients with hepatectomy from January 2012 to December 2013 were randomly divided into LH group and OH group. The changes of liver function, mean incision length, operative time, anesthetic time and intraoperative bleeding were compared between the two groups. Flow cytometry was used to detect and compare the expression of HLA-DR in monocytes and the levels of TNF- 伪, INF- 纬, IL-6 and IL-8 in lipopolysaccharide stimulated cells were detected and compared by flow cytometry. Results the ALT and AST of the two groups increased rapidly after operation, and the difference was significant. The OH group was significantly higher than the LH group. The incision length and bleeding volume in LH group were significantly smaller than those in OH group (P0. 1); LH group, the anesthetic time was longer than that in OH group, but there was no significant difference (P0.05) in). LH group there was no postoperative immune paralysis. On the first day after operation, II major histocompatibility complex increased in LH group, but decreased in open operation group, and the secretion of TNF- 伪, IL-6 and IFN- 纬 in OH group was lower than that in LH group. Conclusion immune paralysis was not found in patients undergoing laparotomy or laparoscopic hepatectomy, but the recovery of immune function in laparoscopic group was better after hepatectomy.
【作者单位】： 海南省海口市人民医院;
【分类号】：R657.3
[Abstract]:Objective to compare the immunosuppression between open surgery and laparoscopic surgery by analyzing the expression of monocyte HLA-DR and cytokine secretion stimulated by in vitro. Methods Fifty patients with hepatectomy from January 2012 to December 2013 were randomly divided into LH group and OH group. The changes of liver function, mean incision length, operative time, anesthetic time and intraoperative bleeding were compared between the two groups. Flow cytometry was used to detect and compare the expression of HLA-DR in monocytes and the levels of TNF- 伪, INF- 纬, IL-6 and IL-8 in lipopolysaccharide stimulated cells were detected and compared by flow cytometry. Results the ALT and AST of the two groups increased rapidly after operation, and the difference was significant. The OH group was significantly higher than the LH group. The incision length and bleeding volume in LH group were significantly smaller than those in OH group (P0. 1); LH group, the anesthetic time was longer than that in OH group, but there was no significant difference (P0.05) in). LH group there was no postoperative immune paralysis. On the first day after operation, II major histocompatibility complex increased in LH group, but decreased in open operation group, and the secretion of TNF- 伪, IL-6 and IFN- 纬 in OH group was lower than that in LH group. Conclusion immune paralysis was not found in patients undergoing laparotomy or laparoscopic hepatectomy, but the recovery of immune function in laparoscopic group was better after hepatectomy.
【作者单位】： 海南省海口市人民医院;
【分类号】：R657.3
【参考文献】
相关期刊论文 前6条
1 马丽娟;吴瑞瑾;林俊;;腹腔镜手术与开腹手术对免疫系统影响的比较[J];国外医学(妇产科学分册);2007年01期
2 沈颖洁;刘U，
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