术后加速康复策略对腹腔镜肝部分切除术患者免疫功能的影响

Effect of Postoperative Accelerated Rehabilitation Strategy on Immune Function in Patients Undergoing Laparoscopic Partial Hepatectomy

目的研究术后加速康复(ERAS)策略对于行腹腔镜肝部分切除术患者免疫功能的影响。方法在2016年6月—2017年10月间来我院就诊的行腹腔镜肝部分切除术患者中选出60例随机分组,随机将患者分成E组(ERAS策略)和C组(常规围术期处理),记录两组患者的手术时间、术中出血量、T细胞亚群免疫指标值。结果E组和C组患者的手术时间和术中出血量比较,差异无统计学意义(P>0.05);E组患者的术后排气时间、住院时间比C组短(P<0.05);且两组患者在手术结束后CD3^+和CD4^+明显降低,而E组患者的降低幅度更小(P<0.05);随着术后恢复,两组患者的CD3^+和CD4^+逐步提高(P<0.05);在CD8^+值上两组患者围手术差异不大,且波动较小(P<0.05)。结论腹腔镜肝部分切除术患者在术后会出现免疫功能降低现象,随着术后的康复免疫功能逐渐恢复;而ERAS的应用能有效减轻手术对患者免疫功能的影响,促进患者免疫功能的恢复,促进患者术后早日康复,值得推广应用。

Objective To study the effect of postoperative accelerated rehabilitation （ERAS） strategy on the immune function of patients undergoing laparoseopic partial hepatectomy. Methods 60 randomized patients were randomly divided into group E （ERAS） and group C （routine circumference） by randomized grouping of patients undergoing laparoscopie par- tial hepatectomy in our hospital from June 2016 to October 2017. The operation time, intraoperative blood loss and T cell sub- population index were recorded. Results There was no significant difference in operation time and intraoperative blood loss between group E and group C （ P 〉 0. 05 ）. The postoperative exhaust time and hospitalization time of group E were shorter than those of group C （P 〈 0. 05） CD3 ＋ and CD4 ＋ in the two groups were significantly lower than those in the control group （ P 〈 0. 05 ）. The CD3＋ and CD4＋ were significantly lower in the E group than in the postoperative group （ P 〈 0. 05 ）. Pa- tient surgery was not very different, and the fluctuation was small （P 〈 0. 05 ）. Conclusion The patients with partial laparo- scopic partial resection of laparotomy have the effect of reducing immune function after operation. With the recovery of im- mune function after operation, the application of ERAS can effectively reduce the effect of surgery on immune function and promote the immune function of patients Recovery, and promote patients with early rehabilitation, it is worth promoting the application.