摘要
目的：探讨自动痔套扎术（RPH）联合硬化剂（消痔灵）注射治疗合并人类免疫缺陷病毒（HIV）感染痔患者的临床疗效及对细胞免疫功能的影响。方法回顾性分析2010年1月至2012年12月间成都市公共卫生临床医疗中心外科接受RPH联合消痔灵注射治疗的76例痔患者临床资料，其中合并HIV感染者36例，HIV阴性者40例。比较两组患者临床疗效和术前1 d、术后7 d及术后30 d外周血中免疫细胞的变化。结果 HIV感染组和HIV阴性组术后6月复发率分别为22．2％（8／36）和22．5％（9／40），术后1年复发率分别为30．6％（11／36）和30．0％（12／40），差异均无统计学意义（均P＞0．05）。两组术后并发症发生率的差异也无统计学意义（P＞0．05）。按HIV感染分级，各组患者术前1 d外周血中淋巴细胞率、CD4计数和CD4／CD8与术后7 d比较，差异有统计学意义（均P＜0．05）；而白细胞计数和中性粒细胞率的差异无统计学意义（P＞0．05）。各组CD4计数下降速度及幅度的高低排序依次为HIV Ⅲ、Ⅱ、Ⅰ级和HIV阴性组；而术后30 d的回升速度及幅度高低排序则相反为HIV阴性、HIV Ⅰ、Ⅱ和Ⅲ级组，与术后7 d指标比较，差异有统计学意义（均P＜0．05）。结论 RPH联合硬化剂注射治疗合并HIV感染的痔患者是安全的，术后处于抑制状态的细胞免疫功能可较快得到恢复。
Objective To explore the efficacy of Ruiyun procedure for hemorrhoids （RPH） combined with Xiaozhiling injection in the treatment of hemorrhoids complicated with human immunodeficiency virus （HIV） infection and its influence on cellular immune function. Methods Clinical data of 76 hemorrhoid patients, including 36 positive HIV and 40 negative HIV, undergoing RPH combined with Xiaozhiling injections in our center from January 2010 to December 2012 were retrospectively analyzed. Clinical efficacy and cellular immune function preoperative day 1 , postoperative day 7, 30 were compared between positive and negative groups. Results Recurrence rates of positive group and negative group postoperative 6 months were 22.2%（8/36） and 22.5%（9/40）, postoperative 1 year were 30.6%（11/36） and 30.0%（12/40） without significant differences （all P〉0.05）. Morbidity of postoperative complication was also not significantly different between two groups （P〉0.05）. According to HIV classification, peripheral lymph cell ratio, CD4 count, CD4/CD8, white blood cell count and neutrophil ratio were not significantly different between preoperative day 1 and postoperative day 7 in both groups （all P〉0.05）. Decreasing velocity and amplitude of CD4 in both groups from high to low was HIV Ⅲ, HIV Ⅱ, HIV Ⅰ, HIV-, while after 30 days the increase of CD4 from high to low was HIV-, HIV Ⅰ, HIV Ⅱ, HIV Ⅲ, which were significantly different as compared to postoperative day 7 （all P〈0.05）. Conclusions RPH combined with Xiaozhiling injection in the treatment of hemorrhoids complicated with HIV infection is effective and safe. Postoperative inhibited cellular immune function can recover quickly.
出处
《中华胃肠外科杂志》
CAS
CSCD
2014年第12期1201-1204,共4页
Chinese Journal of Gastrointestinal Surgery
基金
四川省卫生厅科研基金资助项目
关键词
痔
人类免疫缺陷病毒
自动痔套扎术
硬化剂
疗效
细胞免疫功能
Hemorrhoids
Human immunodeficiency virus
Ruiyun procedure hemorrhoids
Hardener
Clinical efficacy
Cellular Immune Function
