腹腔镜手术CO_2气腹对机体免疫功能的影响  

Effects of CO_2 on Immune Function of Patients Treated by Laparoscopic Operation

作　　者：潘灵辉[1] 林飞[1] 钱卫[1] 赖恩华[1] 黄冰[1] 

机构地区：[1]广西医科大学附属肿瘤医院麻醉科,南宁530021

出　　处：《肿瘤预防与治疗》2009年第3期258-260,共3页Journal of Cancer Control And Treatment

基　　金：广西壮族自治区科学技术自然基金资助项目(NO:桂科基0575088)

摘　　要：目的:观察腹腔镜与开腹妇科手术对机体免疫功能的影响。方法:2004年5月-2007年4月间住院的卵巢良性肿瘤和子宫肌瘤40例,20例接受腹腔镜下手术,20例接受开腹手术,分别于手术前、术后24h及72h抽血检测CD3、CD4、CD8、TNF-α的浓度,并观察其变化。结果:两组患者术后TNF-α浓度与术前相比均明显升高(P<0.01);术后24h、72h血清TNF-α浓度腹腔镜组明显低于开腹手术组(P<0.01);开腹手术组患者在术后24 h、72 h外周血T淋巴细胞亚群CD3、CD4、CD8均明显下降(P<0.01),但腹腔镜组患者在术后24h、72h外周血T淋巴细胞亚群CD3、CD4、CD8的浓度下降与术前比较无统计学意义。结论:腹腔镜手术对免疫功能无明显影响,同时应注意保护开腹患者的术后免疫功能。Objective： To explore the effects of laparoscopic operation and abdominal operation on immune system. Methods： A total of 40 uterimyoma and benign ovarian tumor patients were enrolled in this study, within which 20 patients were treated by laparoscopic approach, and 20 patients were treated by abdominal approach. The tumor necrosis factor-α（TNF -α） and T lymphocyte subpopulation were measured 24 h before, 24 h after, and 72 h after operation, Results： The concentrations of TNF -α in both groups increased significantly after operation（P 〈 0.01 ） ,which were significantly lower in laparoscopic group than that of abdominal approach group（ P 〈 0.01 ）. The postoperative levels of CD3, CD4 and CD8 in abdominal approach group decreased significantly（ P 〈 0.01 ） whereas those of laparoscopic group decreased without statistical significance. Conclusion： Laparoscopic operation does not significantly affect immune function compared with abdominal approach, which suggests that immunity is preserved during the postoperative period.

关 键 词：腹腔镜 T淋巴细胞 肿瘤坏死因子 

分 类 号：R737.3[医药卫生—肿瘤]