【摘要】：目的通過分析單核細胞HLA-DR表達和體外刺激下細胞因子的分泌來比較開腹手術和腹腔鏡手術術后免疫抑制情況。方法將2012年1月-2013年12月內收治的50例行肝切除患者,隨機分為LH組和OH組,比較兩組手術前后部分肝功能指標、平均切口長度、手術時間、麻醉時間及術中出血量的變化。流式細胞儀檢測和比較兩組患者單核細胞HLA-DR的表達特征,ELISA檢測和比較脂多糖刺激后細胞中TNF-α、INF-γ、IL-6及IL-8等炎癥因子的含量。結果兩組術后ALT和AST迅速升高,與術前相比差異顯著,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組中未出現術后免疫麻痹現象。術后第1天LH組II類主要組織相容性復合物升高,而開腹手術組II類主要組織相容性復合物下降。OH組患者術后TNF-α、IL-6和IFN-γ的分泌低于LH組。結論在行開腹或腹腔鏡肝切除術患者中均未發(fā)現免疫麻痹現象,但是腹腔鏡組患者在肝切除后免疫功能恢復情況較好。
[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

【參考文獻】

相關期刊論文 前6條

1 馬麗娟;吳瑞瑾;林俊;;腹腔鏡手術與開腹手術對免疫系統(tǒng)影響的比較[J];國外醫(yī)學(婦產科學分冊);2007年01期

2 沈穎潔;劉U，

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