乌司他丁对老年腹腔镜结肠癌根治术患者红细胞免疫功能的保护

Protective Effect of Ulinastin on Erythrocyte Immunofunction in Senile Patients Undergone Laproscopic Radical Resection of Colonic Cancer

目的:观察围手术期静脉滴注乌司他丁注射液对老年人腹腔镜结肠癌根治术后红细胞免疫功能的保护作用。方法:将90例拟行腹腔镜结肠癌根治术的患者分成3组:A组为青年组,B组为老年组,在手术前后均不给予任何中药治疗;C组为老年组,从术前第3d开始静脉滴注乌司他丁注射液,连用7d。分别在静脉用药前和腹腔镜结肠癌根治术后第1d、4d采取患者外周静脉血测定红细胞C3b受体花结率(RRCR)、红细胞免疫复合物花结率(RRICR)、肿瘤红细胞花结率(RTRR)。结果:术前B组和C组红细胞免疫功能指标明显低于A组(P<0.05)。术后3组RRCR、RRICR、RTRR均呈下降趋势,术后第1dB组和C组明显低于A组(P<0.05),但术后第4dC组与A组比较无明显差异。结论:腹腔镜CO2气腹手术对老年患者红细胞免疫功能仍然有较明显的损害作用,围手术期静脉滴注乌司他丁注射液可以改善老年患者红细胞的免疫功能。

Objective To study the protective effect of peri - operative intravenous administration of ulinastin on the erythroeyte immunofunction in senile patients undergone laparoscopic radical resection of colonic cancer. Methods Peripheral red cell immunofunction parameters （RRCR, RRICR, RTRR） were determined on 3d before operation, dl and d4 after operation in：①30 younger patients with colonic cancer ②30 elderly （over 60） patients with colonic cancer and ③30 elderly patients with colonic cancer receiving intravenous ulinastin 200000 units b. i. d. beginning from 3 days before operation for 7 days. Results Red cell immunofunction as shown by the parameters was significantly lower in elderly patients than those in younger patients pre - operatively （ P 〈 0.05 ）. Post - operatively, the red ceU immunofunction was depressed in all the patients. On dl post - operatively, the red cell immunofunction in elderly patients was much lower in the elderly patients than that in younger patients （P 〈 0.05 ）. However, on d4, the immunofunction in the 30 elderly patients with ulinastin treatmem was not significantly different from that in younger patients. Conclusion Laparoseopie surgery with CO2 pneumoperitoneum caused substantial damage to red cell immunofunetion in senile patients, which might be corrected with peri - operative administration of ttlinastin.