腹腔镜下超声刀与单极电凝钩胆囊切除的T淋巴细胞亚群的变化  

Effects of ultrasonic dissection and unipolar electrocoagulation on T lymphocyte subgroups in laparoscopic cholecystectomy

作　　者：罗朝勇[1] 龙海生[1] 汪峰[1] 陈英[1] 邹家莉[1] 

机构地区：[1]贵阳中医学院第二附属医院贵州省中西医结合肝胆外科中心,贵阳550003

出　　处：《中国微创外科杂志》2007年第7期701-702,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)超声刀与单极电凝钩对T淋巴细胞亚群的影响。方法对50例LC分别采用超声刀(超声刀组,n=25)与单极电凝钩(单级电凝钩组,n=25)手术,术前半小时、术后1d、术后4 d分别从外周血中测定CD3、CD4及CD8淋巴细胞亚群水平,2组进行比较。结果术前半小时2组CD3、CD4、CD8及CD4/8CD无统计学差异(P>0.05);术后1 d 2组病人外周血T淋巴细胞亚群CD3、CD4、CD4/CD8下降、CD8上升,电凝钩组CD3、CD4、CD4/CD8显著低于超声刀组(P<0.05),电凝钩组CD8显著高于超声刀组(P<0.05);术后4 d 2组病人外周血T淋巴细胞亚群均接近正常范围。结论LC使用超声刀比单极电凝钩对机体的免疫功能的影响较小。Objective To investigate effects of ultrasonic dissection and unipolar electrocoagulation on T lymphocyte subgroups in laparoscopic cholecystectomy （LC）. Methods Fifty patients receiving LC by using either ultrasonic scalpel （ Ultrasonic Group, n = 25 ） or unipolar electrocoagulation （ Electrocoagulation Group, n = 25 ） were included in this study. Levels of T lymphocyte subgroups of CD3, CD4, and CD8 in peripheral blood were measured before operation, and on 1 day and 4 days after the operation, respectively. Statistical analyses between the two groups were made. Results No statistical difference was seen between the two groups in levels of CD3, CD4, CD8, and CD4/CD8 before operation （ P 〉 0.05 ）. On the first day after operation, levels of CD3, CD4, and CD4/CD8 were decreased and levels of CD8 were increased in both groups. Moreover, as compared with the Ultrasonic Group, the Electrocoagulation Group had significant lower levels of CD3, CD4, and CD4/CD8 （ P 〈 0.05 ） and significant higher levels of CD8 （P 〈 0.05）. On the fourth day after operation, levels of T lymphocyte subgroups in both groups were close to normal limits. Conclusions During laparoscopic cholecystectomy, ultrasonic dissection exerts less effects on body＇ s immunologic functions than unipolar electrocoagulation.

关 键 词：腹腔镜胆囊切除术 超声刀 单极电凝钩 T细胞亚群 

分 类 号：R657.4[医药卫生—外科学]