全胸腔镜与开胸肺叶切除术对患者围手术期免疫功能的影响  

Effect of lobectomy under video-assisted thoracoscopic surgery or open operation on immune function

作　　者：唐兴[1] 何靖康[1] 马海涛[1] 宋心雨[1] 徐澄澄[1] 

机构地区：[1]苏州大学附属第一医院心胸外科,江苏省215006

出　　处：《江苏医药》2013年第9期1062-1064,共3页Jiangsu Medical Journal

摘　　要：目的探讨全胸腔镜肺叶切除术与开胸肺叶切除术对患者围手术期免疫功能的影响。方法 80例肺叶切除患者随机分为两组,A组35例,采用全胸腔镜肺叶切除术,B组45例,采用开胸肺叶切除术。比较两组手术资料,并采用流式细胞仪检测手术前后外周血CD3+、CD4+、CD8+、CD4+/CD8+及NK细胞水平。结果 A组术中失血量、术后胸管引流时间和引流量、住院时间及术后疼痛时间均少于B组(P<0.05)。术后1d,两组患者CD3+、CD4+、CD4+/CD8+及NK细胞活性较术前均显著降低(P<0.05);术后7d,A组CD3+、CD4+、CD4+/CD8+及NK细胞活性恢复至术前水平。结论与开胸肺叶切除术相比,全胸腔镜肺叶切除术创伤小、恢复快,对患者免疫功能影响小。Objective To compare the perioperative changes of immune function in the patients underwent lobectomy under video-assisted thoracoscopic surgery （VATS） and conventional open operation. Methods Eighty patients underwent lobectomy under VATS（35 cases, group A） and open surgery（45 cases, group B）. The perioperative conditions and the changes of serum CD3＋, CD4＋, CD8＋ ,CD4＋/CD8＋ , and activity of natural killer（NK） cells were measured. Results The operative blood loss, amount and time of drainage, hospital stay, and postoperative pain were all significantly less in group A than those in group B（P〈0. 05）. The expressions of CD3＋, CD4＋ , CD4＋/CD8~ and activity of NK cells were significantly decreased on the 1st day after operation in both groups （P〈0. 05）,which on the 7th day were returned to the normal in group A but were not in group B. Conclusion Compared to conventional open surgery, lobectomy under VATS has the advantages of less injury,faster recovery and less effect on the immune function.

关 键 词：肺叶切除术 电视胸腔镜 免疫功能 

分 类 号：R734[医药卫生—肿瘤]