后腹腔镜输尿管切开取石术对机体免疫功能的影响

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(P0.05)。腹腔镜组IgA、IgG、IgM术后各个时间节点较术前均无差异(P0.05)。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(P0.05)。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。

Influence of retroperitoneal laparoscopic ureterolithotomy on immune function

Objective： To evaluate the impact of retroperitoneal laparoscopic ureterolithotomy on immune func- tion. Method： Sixty patients were randomly divided into retroperitoneal laparoscopic group （30 cases） and tradi- tional open surgery group （30 cases）. Patients were taken blood collection of 8 ml from vein preoperatively, two hours after the surgery,one day,two days and eight days postoperatively. T cell subsets （CD4, CD8） were detec- ted by flow cytometry and serum immunoglobulin （IgA, IgG, IgM） levels were detected by rate immune scatter turbidimetry. Result： This study prompted that CD4, CD8 of retroperitoneal laparoscopic group were shown less declination after the operation, quick recovery and returning to the preoperative levels eight days postoperatively. However, CD4, CD8 of open surgery group were observed more declination after the operation and slow recovery. The level of CD4, CD8 were still lower than the results of preoperative and laparoscopic group （P~0.05）. IgA, IgG, IgM of retroperitoneal laparoscopic group each time after the operation were no differences compared with the preoperative Jevel （P~O. 05）. IgM of open surgery group each time after the operation were no differences com- pared with the preoperative level. IgG of open surgery group began to decline one day after the operation, and still didn＇t recover eight days after the operation. IgA of open surgery group declined more slowly after the operation, and began to be below the preoperative level eight days after the operation （P~O. 05）. Conclusion： Retroperitone- al laparoscopic ureterolithot0my is superior to open surgery for its little effect on somatic cell and humoral immune function.