后腹腔镜与开放性输尿管切开取石术对患者免疫功能影响的比较

发布时间：2018-06-07 11:52

  本文选题：后腹腔镜手术 + 开放手术　； 参考：《中国微创外科杂志》2016年09期

【摘要】：目的比较后腹腔镜与开放性输尿管切开取石术对患者免疫功能的影响。方法回顾性分析我院2013年6月~2015年4月96例输尿管上段结石的临床资料,依据手术方式分为后腹腔镜组50例和开放组46例,比较2种手术方式对机体围手术期免疫功能(包括体液免疫指标IgA、IgG、IgM和细胞免疫指标T细胞CD~(3+)、CD~(4+)、CD~(8+)、CD~(4+)/CD~(8+))的影响。结果后腹腔镜组体液免疫指标IgA、IgG、IgM术后2 h、1 d、7 d与术前2 h比较均无统计学差异(P0.05),开放组IgG术后1 d与术前2 h比较明显下降(P0.05),术后7 d恢复至术前水平(P0.05);2组术后1 d IgA、IgG有统计学差异(P0.05),但其他时点IgA、IgG均无统计学差异(P0.05);2组IgM术后各时间点与术前2 h比较无统计学差异(P0.05)。2组细胞免疫指标T细胞CD~(3+)、CD~(4+)、CD~(8+)、CD~(4+)/CD~(8+)术后2 h、1 d与术前2 h比较均明显下降(P0.05),CD~(3+)、CD~(4+)、CD~(8+)和CD~(4+)/CD~(8+)术后7 d恢复至术前2 h水平(P0.05);术后2 h、1 d后腹腔镜组上述指标明显低于开放组(P0.05),但术后7 d 2组差异无统计学意义(P0.05)。结论后腹腔镜输尿管切开取石术对机体免疫功能的抑制小于传统开放手术。
[Abstract]:Objective to compare the effect of retroperitoneal laparoscopy and open ureterotomy on immune function of patients. Methods the clinical data of 96 cases of upper ureteral calculi in our hospital from June 2013 to April 2015 were retrospectively analyzed. According to the operative methods, 50 cases were divided into retroperitoneal laparoscopic group (50 cases) and open group (46 cases). To compare the effect of two kinds of operation methods on immune function (including humoral immune index IgA CD~(3 and T cell CD~(3) in perioperative period. Results there was no significant difference in the humoral immune index of the laparoscopic group between 2 hours after operation and 2 hours after operation (P 0.05). The level of IgG in the open group decreased significantly 1 day after operation and 2 hours before operation, and recovered to the preoperative level at 7 days after operation. There was no significant difference in IgA IgM IgG at other time points. There was no significant difference between P0.05 group and preoperation 2 hours after IgM. There was no significant difference between P0.05 group and preoperative 2 h group. There was no significant difference between P0.05 group and preoperation group on the cellular immunity index of T cell CD~(3 and CD8 / CD4 / CD8) 2 h after operation and 2 h before operation. At 2 h, the levels of P0.05 / CDT and CD~(4 / CDT / CDT 8) returned to the preoperative level 2 h after operation, and the above indexes in the laparoscopy group were significantly lower than that in the open group at 2 h after 2 h, but there was no significant difference between the two groups on the 7th day after operation (P 0.05), but there was no significant difference between the two groups on the 7th day after operation (P 0. 05 P 0. 05 and P 0. 05%) in the laparoscopy group after 2 hours of operation, but there was no significant difference between the two groups on the 7th day after the operation. Conclusion Laparoscopic ureterotomy has less inhibition on immune function than traditional open surgery.
【作者单位】： 山东省临朐县人民医院泌尿外科;
【分类号】：R699
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本文编号：1991075