腹腔镜胆囊切除术对HIV/AIDS细胞免疫功能的影响  

Laparoscopic cholecystectomy on the impact of HIV / AIDS cellular immune function

作　　者：魏国[1] 温贤敏[1] 范合璋[1] 华欣[1] 何永[1] 蔡林[2] 钟明[1] 何盛华[2] 

机构地区：[1]成都市传染病医院外科,610061 [2]成都市传染病医院感染科,610061

出　　处：《中国实用医药》2013年第7期4-6,共3页China Practical Medicine

基　　金：四川省卫生厅科研基金项目(项目编号:20090013)

摘　　要：目的检测HIV/AIDS患者腹腔镜胆囊切除术前后主要细胞免疫指标的变化并与HIV(一)者对照,探讨微创手术对HIV/AIDS患者主要细胞免疫功能的影响及HIV/AIDS患者实施微创手术的安全性。方法将62例胆囊疾病患者分为2组:观察组(HIV+)30例,对照组HIV(-)32例。用同样方法施行腹腔镜胆囊切除术(Laparoscopic Cholecystectomy,LC)。于观察组术前1d,术后7d、30d检测血常规、CD4、CD8及其百分比和CD4/CD8。对照组于术前1d、术后7d抽外周血,用常规方法检测血常规。观察两组间术后切口感染、腹腔残余感染、肺部感染、机会性感染、围手术期死亡等指标。常规统计学方法处理所得数据。结果对照组术前1d、术后7d白细胞总数、淋巴和中性粒细胞无显著变化(P>0.05);观察组术前1d、术后7d白细胞总数、淋巴和中性粒细胞存在显著变化(P<0.05)。术前1d、术后30d白细胞总数、淋巴和中性粒细胞无显著变化(P>0.05)。观察组术前1d、术后7dCD4、CD8计数及CD4/CD8前后比较存在显著差异(P<0.05)。术前1d、术后30dCD4、CD8计数及CD4/CD8前后比较无显著差异(P<0.05)。2组术后恢复好,无重大并发症或致死并发症发生,无新增机会感染及围手术期死亡发生。结论 LC抑制HIV/AIDS的特异细胞免疫是短暂的。LC对多数HIV/AIDS是安全的,预后较好。T淋巴细胞亚群作为评估主要的风险指标,但需要结合临床分期,综合评估手术安全性。通过合理的术前评估、围手术期抗病毒治疗、术后积极控制机会性感染,HIV/AIDS施行LC手术是安全的。Objective Detection of HIV / AIDS patients with laparoscopic surgery before and after the main indicators of cellular immunity changes, and those who control HIV （-）, to explore minimally invasive surgery for patients with HIV / AIDS immune function affect and HIV / AIDS patients with the implementation of micro-invasive surgery security. Methods 62 cases of gallbladder disease patients were divided into 2 groups： observation group HIV/AIDS 30 cases of the control group HIV （-）of the 32 cases. With the same method laparoscopic cholecystectomy （1aparoscopic cholecystectomy, LC）.The observation group preoperative 1 d, after 7 d, 30 d detect blood count, CD4, CD8 and the percentage and CD4 / CD8. The control group in the preoperative the 1 d, postoperative 7 d pumping peripheral blood, routine blood detected by conventional methods. Observed between the two groups of postoperative wound infection, abdominal residual infections, lung infections, opportunistic infections, perioperative death indicators. Conventional statistical methods to deal with the data obtained. Results In the control group preoperative 1 d, after 7 d WBC count, lymphatic and neutrophils significant change （P 0.05）; day observation group before surgery, after 7 d WBC count, the presence of lymphatic and neutrophilssignificant changes （P0.05）. Preoperative 1 d, the postoperative 30 d WBC count, lymphatic and neutrophils no significant change （P 0.05）. Day observation group preoperative and postoperative 7 d CD4, CD8 count and CD4 / CD8 before and after the existence of significant differences （P0.05）. Preoperative 1 d, postoperative 30 d CD4 and CD8 counts and CD4 / CD8before and after showed no significant differences （P0.05）. 2 postoperative recovery, no major complications or fatal complications occurred, and no new opportunistic infections and perioperative deaths occurred. Conclusion LC inhibition of HIV / AIDS-specific cellular immunity is short-lived. LC majority of HIV / AIDS is a safe and a better prognos

关 键 词：HIV AIDS 腹腔镜胆囊切除术 细胞免疫 

分 类 号：R657.4[医药卫生—外科学]