全脾切除术与部分脾切除术对门静脉高压症脾功能亢进患者免疫功能影响的比较  

The comparison of immune function after splenectomy and partial splenectomy in patients with portal hypertension and hypersplenism

作　　者：张雄杰[1] 毛艳平[1] Zhang XiongJie;Mao Yanping(Hanchuan city people＇s hospital Xiaogan Hubei 431600)

机构地区：[1]汉川市人民医院,湖北孝感431600

出　　处：《中华普外科手术学杂志（电子版）》2018年第5期411-413,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨全脾切除术与部分脾切除术对门静脉高压症脾功能亢进患者免疫功能影响。方法采用随机分组的方法对2013年2月至2016年7月符合纳入标准的146名患者分为两组,全脾切除术组和部分脾切除术组。采用统计软件SPSS20.0进行分析,两组手术指标、免疫指标采用(均值±标准差)表示,独立t检验;两组计数资料的比较使用卡方检验。P<0.05为差异有统计学意义。结果治疗前后比较,两组患者免疫球蛋白、T细胞亚群计数、炎症因子和细胞因子含量指标的差异均具有统计学意义(P<0.05),部分脾切除组患者Ig G、Ig A、Ig M、CD8^+均低于全脾切除组,而IL-1、IL-2、IL-6、TNF-α、TGF-β、CD4^+和CD4^+/CD8^+高于全脾切除组。全脾切除组患者手术时间、失血量、胃肠道功能恢复时间指标均大于部分脾切除组,差异具有统计学意义(P<0.05)。结论门静脉高压症脾功能亢进患者实施部分脾切除术效果更好,值得临床推广。Objective To compare the immune function after total splenectomy and partial splenectomy in patients with portal hypertension and hypersplenism. Methods From February 2013 to July 2016, a total of 146 patients treated in our hospital were studiedand divided into two groups： total splenectomy group and partial splenectomy group Statistical analysis were performed by SPSS20.0, the operation index, immune index of the two groups were compared with independent t test, the multiple sets of normal distribution of measurement data were compared with F test; the comparison of the two sets of counts was performed by the χ^2 test. Results After operation, there were significant difference in immunoglobulin , T cells, inflammatory factors and cytokines between the two groups （ P 〈 0.05）, the level of IgG, IgA, IgM, CD8^＋ were lower in the partial splenectomy group than the total splenectomy group, and as the level of IL-1, 2, IL-6, TNF-α, TGF-β, CD4 ^＋ and CD4 ^＋/CD8 ^＋ were higher in the partial splenectomy group than the total splenectomy group. Conclusions Partial splenectomy surgery is better for patients with portal hypertension and hypersplenism, which is worthy of clinical promotion.

关 键 词：脾切除术 高血压 门静脉 免疫活性 对比研究 

分 类 号：R657.6[医药卫生—外科学]