预存式自体输血对肝癌手术病人炎症反应及免疫功能的影响  

Effect of pre-stored autotransfusion on inflammatory response and immune function in patients undergoing liver cancer surgery

作　　者：李柱威 尹东亮[1] 黎笑兰 王金林[1] 林志强[1] 卢沛林 尹润龙 LI Zhuwei;YIN Dongliang;LI Xiaolan(Department of Hepatobiliary,Pancreatic and Splenic Surgery,Dongguan People's Hospital,Guangdong,Dongguan 523059,China)

机构地区：[1]广东省东莞市人民医院肝胆胰脾外科,523059 [2]广东省东莞市人民医院中药房,523059

出　　处：《临床外科杂志》2021年第11期1034-1037,共4页Journal of Clinical Surgery

基　　金：东莞市社会科技发展(一般)项目资助(NO.201950715001497)。

摘　　要：目的探究预存式自体输血在肝癌手术病人的应用效果以及对炎症反应和免疫功能的影响。方法 2019年6月~2021年2月,拟行开腹肝部分切除术的肝癌病人60例,按输血方式不同分为两组,对照组30例,采用异体输血;观察组30例,采用预存式自体输血。记录两组手术情况。分别于术前及术后1、5天检测两组血清炎症反应和免疫功能指标。记录围术期并发症发生情况。结果两组手术及麻醉时间、尿量、术中出血量和输血量比较,差异均无统计学意义(P>0.05)。对照组术后1、5天及观察组术后1天白细胞介素(IL)-2、CD3+、CD4+、CD4+/CD8+、自然杀伤细胞(natural killer cell, NK)、免疫球蛋白(Ig)G、IgA、IgM水平均低于术前,IL-10、C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α、CD8+水平均高于术前,且观察组术后1、5天IL-2、CD3+、CD4+、CD4+/CD8+、NK、IgG、IgA、IgM水平均高于同时间段对照组,IL-10、CRP、TNF-α、CD8+水平均低于对照组,差异有统计学意义(P<0.05)。观察组输血并发症发生率(0)低于对照组(13.34%),差异有统计学意义(P<0.05)。结论预存式自体输血对肝癌手术病人炎症反应和免疫功能影响较小,安全性好。Objective To explore the effect of pre-stored autotransfusion on patients undergoing liver cancer surgery, as well as the effect on inflammation and immune function.Methods From June 2019 to February 2021,60 cases of liver cancer patients planned to undergo open partial liver resection in our hospital were selected, according to the different blood transfusion methods, they were divided into 30 cases in the control group using allogeneic blood transfusion and 30 cases in the observation group using pre-stored autotransfusion.Record the operation status of the two groups.The serum inflammatory response and immune function indexes of the two groups were tested before operation and 1,5 days after operation.Results There was no significant difference between the two groups in operation and anesthesia time, urine volume, intraoperative blood loss(P>0.05).The levels of IL-2,CD3+,CD4+,CD4+/CD8+,NK,IgG,IgA,IgM in the control group 1,5 days after operation and in the observation group 1 day after operation were lower than those before operation, and the IL-10,CRP,TNF-α,CD8+ levels were higher than before operation, and the IL-2,CD3+,CD4+,CD4+/CD8+,NK,IgG,IgA,IgM levels in the observation group were higher than those in the control group at the same time period, the levels of IL-10,CRP,TNF-α and CD8+ were lower than those in the control group in the same time period(P<0.05).The incidence of complications of blood transfusion in the observation group(0) was lower than in the control group(13.34%,P<0.05).Conclusion Pre-stored autotransfusion has little effect on the inflammation and immune function of patients undergoing liver cancer surgery, and has good safety.

关 键 词：肝癌 预存式自体输血 炎症反应 免疫功能 

分 类 号：R457.1[医药卫生—治疗学] R735.7[医药卫生—临床医学]