摘要
目的比较恶性梗阻性黄疸患者经皮肝穿刺胆道引流(percutaneous transhepatic cholangio drainage PTCD)后放置胆道内支架引流与姑息性开放手术对患者细胞免疫力的影响。方法选取2010年12月份到2012年7月份恶性梗阻性黄疸患者30名,分姑息性手术组和胆道支架组两组,各15名;健康志愿献血者15名作为对照组。于术前第1天、术后第1天、术后第7天、术后第14天抽取手术组患者静脉血,检测血中脂多糖及sIL-2R浓度、CD8+CD28-T细胞含量,比较这三因子对细胞免疫力的抑制作用。结果术前恶性梗阻性黄疸患者较正常人三指标明显增高(P<0.05),在术后各时间点胆道支架组三指标下降幅度大于姑息性手术组(P<0.05)。结论恶性梗阻性黄疸患者细胞免疫力是下降的,胆道支架内引流组患者细胞免疫力恢复较开放性手术内引流组快。
Objective Compared the changes of cell immunity between malignant obstructive jaundice patients with different treatment, placed biliary stent after percutaneous transhepatic cholangio drainage and palliative open surgery. Method Selected 30 patients （male 16 and female 14） with malignant obstructive jaundice came to hospital from 2010 - 12 to 2012 - 1. Put into 2 groups, palliative surgery group and biliary stents group. There were 15 patients （male 7 and female 8） in palliative surgery group and 15 patients （ male 9 and female 6） treated with bile duct biliary stenting. No significant difference in ages, sex and. weights of patients between the 2 groups, Patients had to choose palliative surgery or biliary stents stenting for their conditions were not selected. There were 15 healthy voluntary blood donors in control group. Extracted patients＇ venous blood at 1 day before surgery, 1 day, 7days and 14 days after surgery. Discovered contents of LPS, sIL-2R and CD8 ^＋CD28^-T cells in blood. Compared immunosuppressive effects in the 3 factors. Result Contents of LPS, slL-2R and CD8 ＋ CD28 - T ceils in blood of patients with malignant obstructive jaundice were higher than that in control group（ P 〈 0.05 ）. Contents of the 3 factors at each time after biliary stenting decreased more quickly than after palliative open surgery（P 〈 0.05）. Conclusion cell immunity was restrained in patients with malignant obstructive jaundice, patients with bile duct biliarv stenting were restored more quickly.
出处
《肝胆外科杂志》
2013年第3期192-195,共4页
Journal of Hepatobiliary Surgery
