Objective To explore effects of retroperitoneal laparoscopic operation on stress response and immune function.Methods A total of 48 patients undergoing urinary surgery were enrolled from Tangshan Gongren Hospital from January 2011 to December 2013;24 patients had retroperitoneal laparoscopic operation (observation group) and 24 patients had conventional operation (control group).Interleukin-6 (IL-6),C-reaction protein(CRP),adrenocorticotrophic hormone(ACTH),cortisol,CD3 and CD4 were tested 1 d before and 1,24,72 h after operation.Results The 1 d postoperative level of IL-6 in observation group was significantly higher than the 1 h preoperative level;1,24,72 h postoperative levels of IL-6 in control group were significantly higher than the 1 h preoperative level;there were significant differences of 1,24,72 h postoperative levels of IL-6 between observation group and control group [(23 ± 4) ng/L vs (26 ± 4) ng/L,(20 ± 4) ng/L vs (23 ± 4) ng/L,(17 ± 4) ng/L vs (23 ± 4) ng/L] (P ＜ 0.05).The 1,24,72 h postoperative levels of CRP were significantly higher than the 1 h preoperative level in both groups;there were significant differences of 24,72 h postoperative levels of CRP between observation group and control group [(46.5 ± 13.5) mg/L vs (66.1 ± 15.2) mg/L,(68.6 ± 16.0) mg/L vs (101.5 ± 18.7) mg/L] (P ＜ 0.05).The 1,24 h postoperative levels of A CTH and cortisol were significantly higher than the 1 h preoperative levels in both groups;there were significant differences of 72 h postoperative levels of ACTH and cortisol between observation group and control group [(15.1 ± 2.2) ng/L vs (25.7 ±2.2)ng/L,(13 ±4) mg/L vs (19 ±4)mg/L] (P＜0.05).The 1,24 h postoperative levels of CD3 and CD4 were significantly lower than the 1 h preoperative levels in both groups;there were significant differences of 72 h postoperative levels of CD3 and CD4 between observation group and control group [(68 ± 9) ％ vs (52 ± 9) ％,(47 ± 9) ％ vs (36 ± 9) ％] (P ＜ 0.05).Conclusion Retroperitoneal laparoscopic operation has no adverse effect on stress response and immune function.%目的 探讨后腹腔镜手术对机体应激与免疫功能的影响.方法 选择2011年1月至2013年12月河北省唐山市工人医院泌尿外科收治的需行手术治疗患者48例.根据手术方式不同分为观察组与对照组,各24例,观察组给予后腹腔镜手术治疗,对照组给予常规开放手术治疗,分别检测2组患者术前1d及术后1、24、72 h白细胞介素6(IL-6)、C反应蛋白(CRP)、促肾上腺皮质激素(ACTH)、皮质醇、淋巴细胞CD3、CD4水平,并进行对比分析.结果 ①IL-6:观察组术后1h明显高于术前,对照组术后1、24、72 h均明显高于术前,且术后1、24、72 h观察组明显低于对照组,差异均有统计学意义[(23±4) ng/L比(26 ±4) ng/L、(20 ±4)ng/L比(23 ±4) ng/L、(17±4)ng/L比(23 ±4) ng/L](均P＜0.05).②CRP:2组术后1、24、72 h均明显高于术前,术后24、72 h观察组明显低于对照组,差异均有统计学意义[(46.5±13.5) mg/L比(66.1±15.2)mg/L、(68.6±16.0)mg/L比(101.5±18.7)mg/L](均P＜0.05).③ACTH及皮质醇:2组术后1、24 h均明显高于术前,术后72 h观察组明显低于对照组[(15.1±2.2) ng/L比(25.7±2.2) ng/L、(13 ±.4) mg/L比(19±4) mg/L],差异均有统计学意义(均P＜0.05).④淋巴细胞CD3、CD4:2组术后1、24 h均明显低于术前,术后72 h观察组明显高于对照组,差异均有统计学意义[(68±9)％比(52±9)％、(47±9)％比(36±9)％](均P＜0.05).结论 后腹腔镜手术对机体应激及免疫功能的影响较小,较大程度地维护了机体神经系统及内分泌系统的稳定,有利于患者机体的恢复.
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