腹腔镜巨脾切除术对患者术后免疫功能的影响

目的 观察腹腔镜巨脾切除术对患者免疫功能的影响.方法 将26例巨脾、脾功能亢进患者随机分为腹腔镜巨脾切除组(LS)12例和开腹脾切除组(OS)14例,比较两组病例术前、术后1、7 d外周血淋巴细胞亚群及免疫球蛋白变化.结果 腹腔镜组术后1、7 d的成熟T淋巴细胞(CD3)、辅助T淋巴细胞(CD4)、CD4与抑制淋巴细胞(CD8)的比值及免疫球蛋白IgG、IgA、IgM与术前比较差异无统计学意义(P>0.05).开腹组术后1、7 d的CD3、CD4、CD4/CD8及IgG与术前比较明显下降(P<0.05).结论 腹腔镜巨脾切除术较开放脾切除术对患者免疫抑制程度轻.

Effects of laparoscopic splenectomy for the huge spleen on postoperative immune function

Objective To investigate the effects of the laparoscopic splenectomy for huge spleen on the immune function. Methods Twenty-six patients with huge spleen and hypersplenism were random-ly divided into laparoscipic splenectomy (LS) group and open abdominal splenectomy (OS) group. The changes of peripheral blood lymphocyte subpopulation and immunoglobulin were compared between the two groups before and 1,7 days after operation respectively. Results There was no significant difference in CD3, CD4, CD4/CD8, IgG,IgA ,IgM in LS group before and after operation (P >0.05). CD3, CD4, CD4/ CD8 and IgG in OS group were markedly decreased (P < 0.05 ). Conclusion Laparoscopic splenctomy is less immunosuppresion than open splenctomy.