本文選題：后腹腔鏡手術(shù) + 開(kāi)放手術(shù)�。� 參考：《中國(guó)微創(chuàng)外科雜志》2016年09期

【摘要】：目的比較后腹腔鏡與開(kāi)放性輸尿管切開(kāi)取石術(shù)對(duì)患者免疫功能的影響。方法回顧性分析我院2013年6月~2015年4月96例輸尿管上段結(jié)石的臨床資料,依據(jù)手術(shù)方式分為后腹腔鏡組50例和開(kāi)放組46例,比較2種手術(shù)方式對(duì)機(jī)體圍手術(shù)期免疫功能(包括體液免疫指標(biāo)IgA、IgG、IgM和細(xì)胞免疫指標(biāo)T細(xì)胞CD~(3+)、CD~(4+)、CD~(8+)、CD~(4+)/CD~(8+))的影響。結(jié)果后腹腔鏡組體液免疫指標(biāo)IgA、IgG、IgM術(shù)后2 h、1 d、7 d與術(shù)前2 h比較均無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),開(kāi)放組IgG術(shù)后1 d與術(shù)前2 h比較明顯下降(P0.05),術(shù)后7 d恢復(fù)至術(shù)前水平(P0.05);2組術(shù)后1 d IgA、IgG有統(tǒng)計(jì)學(xué)差異(P0.05),但其他時(shí)點(diǎn)IgA、IgG均無(wú)統(tǒng)計(jì)學(xué)差異(P0.05);2組IgM術(shù)后各時(shí)間點(diǎn)與術(shù)前2 h比較無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。2組細(xì)胞免疫指標(biāo)T細(xì)胞CD~(3+)、CD~(4+)、CD~(8+)、CD~(4+)/CD~(8+)術(shù)后2 h、1 d與術(shù)前2 h比較均明顯下降(P0.05),CD~(3+)、CD~(4+)、CD~(8+)和CD~(4+)/CD~(8+)術(shù)后7 d恢復(fù)至術(shù)前2 h水平(P0.05);術(shù)后2 h、1 d后腹腔鏡組上述指標(biāo)明顯低于開(kāi)放組(P0.05),但術(shù)后7 d 2組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論后腹腔鏡輸尿管切開(kāi)取石術(shù)對(duì)機(jī)體免疫功能的抑制小于傳統(tǒng)開(kāi)放手術(shù)。
[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.
【作者單位】： 山東省臨朐縣人民醫(yī)院泌尿外科;
【分類號(hào)】：R699
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本文編號(hào)：1991075