腹腔镜下根治性肾切除术对机体细胞免疫的影响

Effect of laparoscopic radical nephrectomy on cellular immunity

目的探讨两种手术方式对患者围手术期机体免疫功能的影响。方法 68例接受手术的肾肿瘤患者,按手术方式分为腹腔镜组与开腹组,对其血液样本中的淋巴细胞亚群进行检测,并统计分析。结果腹腔镜组的CD3亚群在术前1 d、术后第1、3、5天比较,差异无统计学意义(P>0.05);开腹组各时间点比较,差异有统计学意义(P<0.05);腹腔镜组的CD4亚群各时间点比较,差异无统计学意义(P>0.05);开腹组各时间点比较,差异有统计学意义(P<0.05);腹腔镜组与开腹组各时间点CD8水平比较,差异均无统计学意义(P>0.05)。腹腔镜组与开腹组各时间点CD25水平比较,差异有统计学意义(P<0.05);腹腔镜组CD69在不同时间点比较,差异无统计学意义(P>0.05),腹腔镜组与开腹组的CD95、CD95L不同时点比较,差异均无统计学意义(P>0.05)。结论腹腔镜手术对患者机体免疫功能的影响小于开腹手术,对患者的应激刺激小,且安全有效,因此应用前景广泛,更易被患者接受,值得临床推广应用。

Objective To explore the effect of laparoscopic radical nephrectomy on cellular immunity. Methods All of 68 patients with renal tumors were divided into laparoscopie group and laparotomy group according to the operation mode. The sample of blood lymphocyte subsets were detected and analyzed. Results The difference of CD3 one day before operation, at first, third, fifth day after operation CD3 in laparoscopic group indicated no statistical significance （P〉0.05）. The difference in laparotomy group showed statistical significance （P〈0.05）. The difference of CD4 in laparo- scopic group indicated no statistical significance（P〉0.05）. The difference in laparotomy group showed statistical signifi- cance （P〈0.05）. The difference of CD8 between two groups indicated no statistical significance （P＇〉0.05）. The differ- ence of CD25 between two groups showed statistical significance （P〈0.05）. The difference of CD69 between two groups indicated no statistical significance （P〉0.05）. The difference of CD95, CD95L between two groups indicated no statisti- cal significance （P〉0.05）. Conclusion Effects of laparoscopic operation on immune function is less than laparotomy op- eration, it is effective and safe, has wide application prospect, more easily accepted by patients, it is worthy of clinical application.