后腹腔镜输尿管切开取石术对机体免疫功能的影响-论文.pdf

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1、2014焦临床泌尿外科杂志29卷2期JClinUrology(China)·1O3·后腹腔镜输尿管切开取石术对机体免疫功能的影响*宋旭张圣熙龚敏王蓉林文耀张耘黄锦阳周磐石俞梦平[摘要]目的：研究后腹腔镜输尿管切开取石术对机体免疫功能的影响。方法：60例输尿管切开取石术患者随机分为后腹腔镜组(30例)和传统开放手术组(30例)，患者术前、手术开始后2h、术后1d、术后2d、术后8d抽取静脉血8ml，T细胞亚群CD4、CD8应用Elite—ESP型流式细胞仪进行分析检测，血清免疫球蛋白IgA、IgG、IgM水平采用免疫速率散射比浊法检测。结果：本研究提示

2、腹腔镜组CD4、CD8手术后下降程度较小，且恢复较快，术后8d均恢复至术前水平。开放手术组术后CD4、CD8下降程度较大，恢复较慢，术后8d仍较术前和腹腔镜组低(P<0．05)。腹腔镜组IgA、IgG、IgM术后各个时间节点较术前均无差异(P>O．05)。开放手术组IgM术后各个时间节点较术前均无差异；IgG术后1d开始下降，术后8d仍未恢复；IgA术后下降较迟，术后8d开始低于术前水平(P<0．05)。结论：后腹腔镜输尿管切开取石术与开放手术比较，其对机体细胞免疫和体液免疫功能影响较小，体现了微创优势。[关键词]后腹腔镜手术；免疫功能doi：10．

3、13201／j．issn．1001—1420．2014．02．004[中图分类号]R699．4[文献标识码]AInfluence0fretr0peritOneallaparoscopicureterolithotomyonimmunefunctionSoNGxHZHANGShengxiGongMinWANGRongLINWenyaoZHANGYunHUANGJingyangZHOUPanshiyUMengping(DepartmentofUrology，ShanghaiSeventhPeople'sHospital，Shanghai，200137，C

4、hina)C0rresp0ndingauthor：SONGXu，E—mail：1418855811(qq．cornAbstract0ective：Toevaluatetheimpactofretroperitoneallaparoscopicureterolithotomyonimmunefunc—tion．Method：Sixtypatientswererandomlydividedintoretr0peritoneallaparoscopicgroup(30cases)andtradi—tionalopensurgerygroup(30cases

5、)．Patientsweretakenbloodcollectionof8mlfromveinpreoperatively，twohoursafterthesurgery，oneday，twodaysandeightdayspostoperative1y．Tcellsubsets(CD4，CD8)weredetec—tedbyflowcytometryandserumimmunoglobulin(IgA，IgG，IgM)levelsweredetectedbyrateimmunescatterturbidimetry．Result：Thisstudy

6、promptedthatCD4，CD8ofretroperitoneallaparoscopicgroupwereshownlessdeclinationaftertheoperation，quickrecoveryandreturningtothepreoperativelevelseightdayspostoperatiVely．However，CD4，CD8ofopensurgerygroupwereobservedmoredeclinationaftertheoperationandslowrecovery．ThelevelofCD4，CD8

7、werestilllowerthantheresultsofpreoperativeandlaparoscopicgroup(P<0．05)．IgA，IgG，IgMofretroperitoneallaparoscopicgroupeachtimeaftertheoperationwerenodifferencescomparedwiththepreoperativeJevel(P>0．05)．IgMofopensurgerygroupeachtimeaftertheoperationwerenodifferencescorn—paredwithth

8、epreoperativeleve1．IgGofopensurgerygroupbegantodecline