摘要
目的探讨腹腔镜辅助微创肝胆外科手术对患者免疫系统的影响。方法收集沈阳军区总医院肝胆外科收治的101例患者的临床资料,根据手术方式的不同分为3组:常规开腹手术(CS)组48例,腹腔镜手术(LS)组50例,及达芬奇机器人手术(ROB)组3例。术前及术后1 d、3 d抽取空腹外周血,测定其C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)浓度以及CD4+T细胞/CD8+T细胞比率、自然杀伤细胞(NK)数;选取改良疼痛尺评价术后疼痛情况。结果 ROB组CRP、TNF-α、IL-6升幅,CD4+T细胞/CD8+T细胞比率、NK细胞数降幅和疼痛评分最低,最快恢复至正常水平。LS组的对应情况略逊色,而CS组最不理想。结论腹腔镜微创手术,尤其是机器人微创手术,创伤小,对免疫功能影响低,术后恢复快,具有较好的临床应用价值。
Objective To explore the influence of laparoscope-aided minimally invasive surgery on the immune system of patients with hepatobiliary diseases. Methods Forty-eight cases of conventional laparotomies,fifty cases of laparoscope-aided minimally invasive surgeries and three cases of robot-aided minimally invasive surgeries were recruited respectively,and general information of all the patients were obtained. Fasting blood samples were collected preoperatively,at the first and second days postoperatively. CRP,TNF-α and IL-6 concentrations,CD4^＋T cell / CD8^＋T cell ratio and NK cell number were then measured. Additionally,modified pain ruler was taken to assess the pain postoperatively. Results Increments of CRP,TNF-α and IL-6 concentrations,decrements of CD4^＋T cell / CD8^＋T cell ratio and NK cell number and pain score of the robotic group were minimal as compared to the other two groups;immunity of the robotic group recovered quickest. However,the corresponding situation of the laparoscopic group was less desirable and that of the laparotomy group was least desirable. Conclusion Laparoscope-aided minimally invasive surgery,especially robot-aided minimally invasive surgery,is of clinical value owing to minor injury,less immunological disturbance and quick recovery.
出处
《创伤与急危重病医学》
2015年第3期160-162,共3页
Trauma and Critical Care Medicine
基金
2013年度全军医学科技青年培育项目计划(13QNP004)
关键词
微创手术
机器人手术
腹腔镜
免疫功能
肝胆外科
开腹手术
minimally invasive surgery
robotic surgery
laparoscope
immunity
hepatobiliary surgery
laparotomy
