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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(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>0.05)。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。
Objective: To study the effect of laparoscopic ureterolithotomy on immune function. Methods: Sixty patients undergoing ureterolithotomy were randomly divided into retroperitoneal laparoscopic group (n = 30) and traditional open surgery group (n = 30). The patients underwent preoperative 2h, postoperative 1d, postoperative 2d, 8ml venous blood samples were collected 8ml, T cell subsets CD4, CD8 using Elite-ESP-type flow cytometry analysis of detection, serum immunoglobulin IgA, IgG, IgM levels by immunostaining turbidimetric assay. Results: This study suggests that laparoscopic group CD4, CD8 decreased less after surgery, and recovery faster, 8d after surgery were restored to the preoperative level. In the open surgery group, the CD4 and CD8 descended more slowly and recovered slowly, still lower than preoperative and laparoscopic group 8d after operation (P <0.05). Laparoscopic group IgA, IgG, IgM postoperative nodes at all time points compared with preoperative no difference (P> 0.05). There was no difference between the two groups in the open surgery group at all time points after operation; the level of IgM decreased at 1 day after operation and remained unchanged at 8 days after operation; the level of IgA decreased later than that at the 8th day after surgery (P <0.05) ). Conclusions: Retroperitoneoscopic laparoscopic ureterolithotomy and open surgery have less effect on cellular immunity and humoral immune function, which reflects the advantage of minimally invasive surgery.