【摘要】：目的通過分析單核細(xì)胞HLA-DR表達(dá)和體外刺激下細(xì)胞因子的分泌來比較開腹手術(shù)和腹腔鏡手術(shù)術(shù)后免疫抑制情況。方法將2012年1月-2013年12月內(nèi)收治的50例行肝切除患者,隨機分為LH組和OH組,比較兩組手術(shù)前后部分肝功能指標(biāo)、平均切口長度、手術(shù)時間、麻醉時間及術(shù)中出血量的變化。流式細(xì)胞儀檢測和比較兩組患者單核細(xì)胞HLA-DR的表達(dá)特征,ELISA檢測和比較脂多糖刺激后細(xì)胞中TNF-α、INF-γ、IL-6及IL-8等炎癥因子的含量。結(jié)果兩組術(shù)后ALT和AST迅速升高,與術(shù)前相比差異顯著,而且OH組明顯高于LH組。切口長度和出血量LH組明顯小于OH組(P0.1);LH組手術(shù)時間、麻醉時間長于OH組,但差異無顯著性(P0.05)。LH組中未出現(xiàn)術(shù)后免疫麻痹現(xiàn)象。術(shù)后第1天LH組II類主要組織相容性復(fù)合物升高,而開腹手術(shù)組II類主要組織相容性復(fù)合物下降。OH組患者術(shù)后TNF-α、IL-6和IFN-γ的分泌低于LH組。結(jié)論在行開腹或腹腔鏡肝切除術(shù)患者中均未發(fā)現(xiàn)免疫麻痹現(xiàn)象,但是腹腔鏡組患者在肝切除后免疫功能恢復(fù)情況較好。
[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- 偽, INF- 緯, 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- 偽, IL-6 and IFN- 緯 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.
【作者單位】： 海南省�？谑腥嗣襻t(yī)院;
【分類號】：R657.3

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本文編號：2393865