急性高容量性血液稀释对妇科肿瘤患者围术期T淋巴细胞亚群的影响  

Influences of Acute Hypervolemic Hemodilution on perioperative T-lymphocyte subsets in patients with gynecologic tumor.

作　　者：何桂香 房玲玲[2] 蒋明星 赵春虹 陈钢[2] 

机构地区：[1]浙江省诸暨市妇幼保健院,诸暨311800 [2]浙江大学医学院附属第二医院,诸暨311800

出　　处：《浙江创伤外科》2005年第1期7-9,共3页Zhejiang Journal of Traumatic Surgery

摘　　要：目的探讨急性高容量性血液稀释(AHH)对妇科肿瘤患者围手术期T淋巴细胞亚群的影响。方法40例ASAⅠ～Ⅱ级的妇科肿瘤手术病人随机分成两组:高容量性血液稀释组(A组)在切皮前30分钟内输入6%羟乙基淀粉液1000ml;对照组(C组)常规输液,不实施血液稀释。分别与麻醉诱导前、手术结束后、术后24小时抽取静脉血,用流式细胞仪测定T淋巴细胞亚群CD_3^+、CD_4^+、CD_8^+及CD_4^+/CD_8^+细胞百分率。结果两组病人手术结束后(T1)、手术后第1天(T2)与麻醉诱导前(T0)比较:T淋巴细胞亚群CD_3^+、CD_4^+及CD_4^+/CD_8^+均明显降低(P<0.01或P<0.05),CD_8^+无显著性变化;但A组手术结束后和手术后第1天CD_3^+、CD_4^+及CD_4^+/CD_8^+明显高于C组(P<0.05)。结论术前采用急性高容量性血液稀释(AHH),可显著改善妇科肿瘤患者T淋巴细胞的免疫功能。Objective To evaluate the effects of preoperative Acute Hypervolemic Hemodilution (AHH) with 6% hydroxyethyl starch (200/0.5) on counts of T-lymphocyte subsets in patients with gynecologic tumor during perioperative period. Methods 40 ASA Ⅰ～Ⅱ patients undergoing gynecologic tumors had been operation prospectively randomized to two groups: Acute Hypervolemic Hemodilution group (group A),after general anesthesia inducing,hemodilution was achieved by the internal jugular vein infusion of 1000ml hygroxyethl starch within thirty minutes; comparative group (group C) received routine infusion.The venous blood samples were taken before anesthesia inducing,after operation and on the 1st postoperative day to measure counts of T-lymphocyte subsets (CD3+,CD4+,CD8+,CD4+/CD8+ ratio) with flow cytometry. Results The counts of CD3+,CD4+,CD4+/CD8+ in both groups decreased significantly after operation and on the 1st postoperative day(P<0.05 or P<0.01),but In the group C,CD3+,CD4+,CD4+/CD8+ decreased significantly after operation and on the 1st postoperative day compared with group A(P<0.05).There was no significant difference in CD8+ during perioperative period. Conclusions AHH can improve the immunity of T-lymphocytes in patients with gynecologic tumors during perioperative period.

关 键 词：血液稀释 T淋巴细胞亚群 妇科肿瘤 急性 患者 CD3^+ CD4^+/CD8^+ 常规 输入 

分 类 号：R737.3[医药卫生—肿瘤] R614[医药卫生—临床医学]