围手术期输血加温对恶性肿瘤患者细胞免疫功能的影响  

Effect of Perioperative Blood Transfusion Warming on Cellular Immune Function in Patients with Malignant Tumor

作　　者：王宏梗[1] 黄志军[1] 范春梅[1] 陈汝聘[1] 黄倩[1] WANG Honggeng;HUANG Zhijun;FAN Chunmei;CHEN Rupin;HUANG Qian(Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China)

机构地区：[1]福建医科大学附属第二医院

出　　处：《中外医学研究》2020年第3期27-29,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：福建省医学创新课题项目(项目编号：2016CX-39)

摘　　要：目的:围手术期输血加温对恶性肿瘤患者的细胞免疫功能影响。方法:选取2017年3月-2018年12月在笔者所在医院行胸腹腔恶性肿瘤根治性手术的患者40例为研究对象,随机分为加温组与对照组,对照组患者在围手术期常温下输液,输血前通过室温复温30 min后进行输注,加温组患者围手术期进行加温输血和输液,在术前、术后1 d、术后7 d及术后30 d抽取静脉血检测两组患者免疫功能指标、炎症细胞因子变化。结果:术前,两组患者的免疫功能指标对比差异无统计学意义(P>0.05),与术前比较,两组患者的CD3^+、CD4^+、CD4^+/CD8^+、NK细胞值均呈下降的趋势,但加温组患者的上述指标下降程度低于对照组(P<0.05);术前,两组患者炎症反应指标对比差异无统计学意义(P>0.05),术后1 d,两组患者TNF-α、IL-8、IL-6水平均较术前升高,但加温组患者TNF-α、IL-8、IL-6水平明显低于对照组(P<0.05)。结论:围手术期输血加温能够减轻对恶性肿瘤患者的细胞免疫功能的影响,并能有效减轻应激反应。Objective:To investigate the effect of blood transfusion warming on the cellular immune function in patients with malignant tumor.Method:Forty patients undergoing radical surgery for malignant tumors of chest and abdominal cavity in our hospital from March 2017 to December 2018 were randomly divided into warming group and control group.The patients in the control group were infused at room temperature during the perioperative period,the patients in the control group were infused with 30 min at room temperature before blood transfusion,and the patients in the warming group underwent warm blood transfusion and infusion during the perioperative period.Venous blood samples were taken 1,7 d after operation and 30 days after operation to detect the changes of immune function and inflammatory cytokines in the two groups.Result:Before operation,there was no significant difference in immune function between the two groups(P>0.05).The values of CD3,CD4,CD4/CD8 and NK cells in the two groups decreased,but the degree of decrease in the above indexes in the warming group was lower than those in the control group(P<0.05).There was no significant difference in inflammatory response between the two groups before operation(P>0.05).On the 1 st day after operation,the levels of TNF-α and IL-8,IL-6 in the two groups were significantly higher than those before operation,but the levels of TNF-α and IL-8,IL-6 in the warming group were significantly lower than those in the control group(P<0.05).Conclusion:Perioperative blood transfusion warming can reduce the effect on cellular immune function of malignant tumor patients and effectively reduce stress response.

关 键 词：围手术期 输血加温 恶性肿瘤 细胞免疫功能 

分 类 号：R730.5[医药卫生—肿瘤]