围手术期急性非等容量血液稀释对肿瘤患者术后免疫力及早期并发症的影响  

EFFECT OF ACUTE NON-ISOVOLEMIC HEMEDILUTION ON EARLY COMPLICATIONS IN PATIENTS UNDERGOING SURGERY

作　　者：刘旺 

机构地区：[1]汕尾市人民医院,广东汕尾516600

出　　处：《现代医院》2009年第6期22-24,共3页Modern Hospitals

摘　　要：目的探讨围手术期进行急性非等容量血液稀释(ANIH)对肿瘤患者免疫功能以及早期并发症的影响。方法选择60例肿瘤患者分为2组,30例ANIH组围手术期进行ANIH,30例对照组术前为常规处理。所有患者稀释前、稀释后和术后24h用流式细胞仪测量T淋巴细胞亚群(CD3,CD4,CD8),并观察他们早期并发症发生率。结果稀释后ANIH组与稀释前CD3,CD4T淋巴细胞亚群水平有显著性差异(p<0.05),而稀释后24h与稀释前差异均不显著(p>0.05);稀释后ANIH组与同时间段对照组患者CD3,CD4T淋巴细胞亚群水平差异显著(p<0.05),而稀释前与稀释后24h与对照组差异不显著(p>0.05)。不同时间段或者不同组间CD8T淋巴细胞亚群水平差异均不显著。稀释后ANIH组与对照组患者相比,感染以及总并发症发生率有显著性差异(p<0.05)。结论围手术期进行ANIH可以提高肿瘤患者T淋巴细胞亚群水平,减少感染等早期并发症比率。Objective To study the effect of acute non - isovolemic hemedilution on early complications in patients undergoing tumoreetomy. Methods 60 patients were divided into 2 groups： control group （ n = 30） and acute non- isovolemic hemedilution（ANIH） group （n =30）. The patients in control group were received routine treatment before operation and the patients in ANIH group were proceeded by preoperative infusion of 15 mL/kg of 60 g/L hydroxyethyl starch（HES） at the rate of 50mL/min with removing blood （10% - 15% of the blood amount in a patient）. The proportion of lymphocyte subpopulation such as CD3 ,CD4 and CD8 were deteeted at the time before operation, 1 h after bemodilution and 24h after the operation in all patients. The early complications were observed in all patients too. Results [ 1 ] In ANIH group,the proportion of CD3 and CD4 in patients before operation were lower than that in patients at 1 h after hemodilution（p 〈0. 05） ,but were indifferent with that in patients at 24 h after hemodilution（p 〉0. 05）. [2]At lh after hemodilution,the proportion of CD3 and CD4 in patients in ANIH group were higher than that in control group（p 〈0. 05） ,But at the time before operation or at 24 h after bemodilution,this difference were insignificant （p 〉 0.05 ）. Never among different time or between different group, the proportion difference of CD8 of patients were insignificant too（p 〉0.05）. The rate of infection or the rate of the total early complication in ANIH group patients were all lower than that in control group patients（p 〈 0. 05 ）. Conclusion ANIH can enhance the immune competence and decrease the rate of early complication, especially for infection complication in patients undergoing tumoreetomy.

关 键 词：急性非等容量血液稀释 肿瘤 免疫 

分 类 号：R457[医药卫生—治疗学] R654.2[医药卫生—临床医学]