HIV感染外科患者腔镜手术围手术期的处理

Perioperative management of endoscopic surgery in HIV infection surgical patients

目的探索人类免疫缺陷病毒(HIV)感染外科患者腔镜下手术围手术期的处理经验。方法回顾性分析该院外科接受腹腔镜手术治疗的HIV感染患者267例,部分通过术前应用高效逆转录病毒疗法(HAART),根据CD4+T淋巴细胞水平制定合适的手术治疗方案,对手术前后CD4+T淋巴细胞、白细胞进行比较。结果 267例手术患者有5例切口感染,2例泌尿系感染,经相关处理外科疾病全部治愈,无死亡病例,术前术后CD4+T/WBC计数差异无统计学意义(P>0.05)。结论严格掌握手术适应证,充分的术前准备、减少术中对机体的影响,加快术后恢复,是HIV感染外科患者围手术期的关键。

【Objective】To explore the experience of endoscopic perioperative management of human immunodeficiency virus（HIV） infection in surgical patients.【Methods】A total of 267 laparoscopic surgical patients with HIV infection in our hospital were retrospectively analyzed, some patients were treated with highly active antiretroviral therapy（HAART）, and the appropriate surgical treatment was developed according to the level of CD4＋T lymphocytes, preoperative and postoperative counts of CD4＋T lymphocytes and white blood cells were compared.【Results】There were five cases of incision infection and two cases of urinary system infection in 267 cases. After the relevant treatment, all the surgical diseases were cured without any death. And the white blood cells and CD4＋T lymphocytes showed no significant changes after the operation.【Conclusion】For perioperative surgical patients with HIV infection, it is the key to strictly control surgical indications, make adequate preoperative preparation, reduce intraoperative impact on the body and speed up postoperative recovery.