肝癌病人术后早期复温对免疫功能影响的临床研究

目的]探讨不同复温时间对肝癌部分切除术低体温病人免疫功能的影响。方法]将90例低体温病人依不同复温时间随机分3组,A组30 min、B组30 min~60min、C组60min,每组30例。术前、术后1d、2d测外周血白细胞介素(IL)-2,IL-6;术前、术后1d、5d测外周血T细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)。结果]C组1dCD3+、CD4+、CD4+/CD8+及5dCD4+/CD8+低于A组、B组(P0.05)。3组病人T细胞亚群重复方差分析,各指标时间效应、交互效应、CD3+、CD4+、CD4+/CD8+组间效应P0.05。各组CD8+术前与术后、组间比较差异无统计学意义(P0.05)。C组术后1d、2dIL-2低于A组、B组,C组术后2dIL-6高于A组、B组(P0.05)。IL-2组间效应、IL-6组间效应、时间效应及交互效应P0.05。结论]复温时间60min可延迟免疫恢复,肝癌病人术后早期有效复温能减轻免疫抑制,利于病人术后康复。

Clinical study on influence of postoperative early rewarming on immune function of patients with l iver cancer

Objective：To probe into the influence of different rewarming time on immune function of liver cancer patients complicated with hypothermia after hepatectomy.Methods：A total of 90 cases of hypothermia patients were randomly divided into 3 groups according to the rewarming time：A group（〈30 min）,B group（30 min to 60 min）and C group（〉60min）,30 cases in each. The plasma IL- 2 and IL- 6 were measured on preoperative and postoperative 1st,2th day;and T lymphocyte subsets（CD3^＋,CD4^＋,CD8^＋,CD4^＋/CD8^＋） were measured on preoperative and postoperative 1st,5th day.Results：CD3^＋,CD4^＋ on the 1st day after operation and CD4^＋/CD8^＋ on 5th day were the lowest in group C（P〈0.05）.T cell subsets repeated analysis of variance in three groups of patients showed that the time effect,interaction effect and CD3^＋,CD4^＋,CD4^＋/CD8^＋ between group effect in all indexes were different （P〈0.05）.There was no difference in CD8 ^＋ in all groups before and after surgery and comparison between groups（P〉0.05）.On the postoperative 1st and 2th day,IL- 2 was the lowest in group C;IL 6 was the highest in group C on the postoperative 2th day （P〈0.05）.There was between group effect in IL -2,the between group effect,time effect and interaction effect in IL -6 P〈0.05.Conclusion：The rewarming time was longer than 60min,which would delay the recovery of immune function.Early postoperative effective rewarming can reduce immunosuppression and is profit for postoperative recovery of patients.