后腹腔镜手术对患者机体免疫功能影响的研究

Influence of retroperitoneal laparoscopic surgery on immune function of organism

目的探讨后腹腔镜手术对泌尿系疾病患者免疫功能的影响。方法选择2011年1月至2013年12月期间收治的需手术治疗的泌尿系疾病患者84例,按随机数字表法将其分为观察组与对照组,各42例。观察组给予后腹腔镜手术治疗,对照组给予常规手术治疗,分别检测两组患者术前、术后1、24、72 h的血清白细胞介素(IL)-6水平及T淋巴细胞亚群CD3、CD4百分率,并进行对比分析。结果 (1)IL-6水平:观察组仅术后1 h显著高于术前(P<0.05),对照组术后1、24、72 h既显著高于术前(P均<0.05),也显著高于观察组(P均<0.05)。(2)CD3、CD4百分率:两组患者术后1 h均较术前显著降低(P均<0.05);其后均逐渐回升,至术后72 h,观察组回升至术前水平,对照组仍低于术前1 d,术后72 h观察组显著高于对照组(P均<0.05)。结论后腹腔镜手术对机体免疫功能的影响较小,较大程度维护了机体神经及内分泌系统的稳定,有利于机体的恢复。

Objective To discuss the clinical influence of retroperitoneal laparoscopic operation on immune function of or- ganism in patients with urinary system disease （USD）. Methods Eighty-four patients with USD operated between January 2011 and December 2013 were divided into the observation group and the control group （n = 42 each） according to random number table. The patients in observation group underwent retroperitoneal laparoscopic operation and the patients in control group underwent routine operation. Then, serum interleukin-6 （ IL-6 ）, percentage of serum T lymphocyle subset [ cluster of differentiation（CD） 3 and C D4 ] were detected before operation and at l-h, 24-h, 72-h after the operation. The test results were analyzed and compared between the two groups. Results In the observation group, the serum level of IL-6 was signifi- cantly higher only at 1-h post-operation than pre-operation （P 〈 0.05 ）. In the control group, the serum levels of IL-6 at l- h,24-h,72-h post-operation were significantly higher than those pre-operation and those in observation group （all P 〈 0.05 ）. The percentage of CD3 and CD4 in the two groups reduced significantly one hour after operation compared with be- fore operation （all P 〈 0.05 ） and then recovered gradually. At 72-h after operation, the percentage of CD3 and CD4 rised to the preopretive levels in the observation group and were still lower tban those before operation in the control group. There were significantly differences between the observation group and the control group （ all P 〈 0.05 ）. Conclusion The retro- peritoneal laparoscopic operation has relatively less influence on immune function and so maintains the stability of nerve and endocrine system for the recovery of the body.