HIV/AIDS合并急腹症或腹部外伤患者应用腹腔镜技术的临床观察

Clinical effect of laparoscopy in patients with HIV/AIDS complicated with acute abdomen or abdominal trauma

目的观察HIV/AIDS合并急腹症或腹部外伤患者应用腹腔镜技术的临床效果。方法将医院收治的HIV/AIDS合并急腹症患者116例作为研究对象,随机分为对照组和观察组,每组58例。对照组接受开放性手术治疗,观察组接受腹腔镜手术治疗,比较2组手术前后白细胞计数、IgG、IgM以及CD_4/CD_8免疫指标。结果手术前,2组白细胞计数比较无明显差异(P>0. 05),2组手术后白细胞计数均有所增加,且观察组增加幅度高于对照组(P <0. 01),手术前后2组IgG、IgM水平均无明显变化(P> 0. 05); 2组手术前后CD_4/CD_8值比较无明显差异(P> 0. 05)。结论针对HIV/AIDS合并急腹症或腹部外伤患者应用腹腔镜技术,能够使HIV/AIDS感染者的特异性细胞免疫得到轻度抑制,但效果短暂,且对HIV/AIDS感染者的体液免疫无明显影响。

Objective To observe the clinical effect of laparoscopy in patients with HIV/AIDS complicated with acute abdomen or abdominal trauma. Methods One hundred and sixteen cases of HIV/AIDS patients with acute abdomen were randomly divided into observation group and control group,58 cases in each group. The control group received open surgery,while the observation group received laparoscopic surgery. Leukocyte count,IgG,IgM and CD4/CD8 immune indices were compared between the two groups before and after operation. Results Before operation,there was no significant difference in white blood cell count between the two groups( P > 0. 05). After operation,the white blood cell count increased in both groups,and the increase in the observation group was higher than that in the control group( P < 0. 01). There were no significant changes in IgG and IgM levels in both groups before and after operation( P > 0. 05). There was no significant difference in CD4/CD8 between the two groups before and after operation( P > 0. 05). Conclusion The application of laparoscopy in the treatment of HIV/AIDS patients with acute abdomen or abdominal trauma can slightly inhibit the specific cellular immunity of HIV/AIDS infected patients,but the effect is short,and it has no obvious effect on the humoral immunity of HIV/AIDS infected patients.