输血对食管癌病人免疫功能的影响

The effect of blood transfusion during esophagectomy on immune function for patient with esophageal carcinoma

目的 探讨输血对食管癌病人免疫功能的影响。方法 95例食管癌病人围术期输血者49例、未输血者 46例 ,于术前、术后 1、3、7、14d分别检查细胞及体液免疫指标———外周血T淋巴细胞及其亚群和血浆TNF、红细胞C3b受体花环及免疫复合物花环试验、血清中红细胞免疫调节因子活性、肿瘤红细胞花环试验 (促、直、协 )、自然肿瘤红细胞花环试验NTERT ;血清中IgG、IgA、IgM、C3 、C4 的含量。结果 两组间感染并发症发生率无差异 (11 0 %与 15 2 % ,P >0 0 5 )。输血组术后各免疫学指标受抑程度较未输血组更著 (P <0 0 5 )、持续时间更长 (P <0 0 1)。

Objective: Blood transfusion can increase the incidence of postoperative infectious complications, and promote cancer growth and metastasis due to its immune suppression. We evaluated the effects of blood transfusion, during esophagectomy of immune function in the patients with esophageal carcinoma. Methods: The study consisted of 95 patients with esophageal carcinoma, all patients underwent esophagectomy. The patients were divided into blood transfusion group (n=49) and non blood transfusion group (n=46) . The immune function test was formed before operation, immediately after anesthesia, on 1st, 2nd, 7th and 14th day after operation . Results: The immune function indexes was lower in blood transfusion group than that in non transfusion group. The incidence of postoperative infectious complication was different in these two groups. Conclusion: Esophagectomy could be performed without blood transfusion. Blood transfusion may aggravate the immune suppression in the patient with esophageal carcinoma after esophagectomy .