摘要
目的对比腔镜下甲状腺手术与传统开放手术对患者免疫功能的影响。方法以甲状腺良性疾病部分甲状腺切除患者为观察对象,其中经腔镜下甲状腺手术68例为腔镜组,行开放式手术患者56例为传统组。对比分析两组术前、术后24、72 h免疫球蛋白(IgM、IgG、IgA)、血清IL-6、TNF-α水平,流式细胞术检测CD3、CD4、CD8阳性细胞百分率及CD4/CD8比值。结果免疫球蛋白在两组术后24 h及72 h与术前相比均无显著差异(P>0.05),各时相两组相比亦无显著差异(P>0.05)。IL-6、TNF-α在腔镜组和传统组术后24 h均较术前显著升高(P<0.05或P<0.01),术后72 h与术前相比均无显著差异(P>0.05);两组相比,IL-6及TNF-α在术前、术后24、72 h均无显著差异(P>0.05)。术后24 h,各组CD3、CD4、CD8均较术前显著降低(P<0.05);术后72 h与术前相比无显著差异(P>0.05),两组相比均无显著差异(P>0.05)。结论腔镜手术和传统开放式手术均可抑制患者的免疫功能,尤其以抑制细胞免疫为主,但两种手术方式对机体免疫功能影响并无显著差异。
Objective To compare the impact of endoscopic thyroid surgery and traditional open thyroid surgery on immune function of the patients. Methods 124 patients with benign thyroid diseases undergoing partial thyroidectomy were divided into 2 groups ： endoscopic surgery group （ n = 68 ） and open surgery group （ n = 56 ） ; a comparative study was made to the levels of immunoglobulin （ IgM, IgG, IgA）, intedeukin-6 （ IL-6）, TNF-ot, positive percentage of CD3, CIM, CD8 and the ratio of CIM/CD8 at the time points of before operation,24 hours and 72 hours after operation between the patients in the 2 groups. Results The levels of IgM, IgG, IgA of the patients in both groups at the time point of 24 hours and 72 hours after operation were of no obvious difference from those of them before operation（ P 〉 0.05 ）, while existed no differenee at each time point between the 2 groups （ P 〉 0.05 ） ; the levels of IL-6,TNF-ct at the time point of 24 hours after operation in both groups were higher than those of them before operation （P 〉 0.05 ）, but indifferent from those of them at the time point of 72 hours after operation （ P 〉 0.05 ）, while the comparison between the 2 groups showed no obvious difference in IL-6 and TNF-ct at each time point（P 〉 0.05） ;the positive percentages of CD3, CD4, CD8 at the time point of 24 hours after operation in each group were lower than those before operation （ P 〉 0.05 ） and returned to the baseline before operation（P 〉 0.05 ） at the time point of 72 hours after operation, no difference was found between the 2 groups （ P 〉 0.05 ）. Conclusions Both endoscopic thyroid surgery and open thyroid surgery inhabit the immune function of the patients, especially the cellular immunity;thyroid surgery with the 2 approaches is of no significant difference in the impact on immune function.
出处
《西南国防医药》
CAS
2014年第4期395-398,共4页
Medical Journal of National Defending Forces in Southwest China
关键词
甲状腺
腔镜
开放手术
免疫功能
thyroid
endoscope
open surgery
immune function
