摘要
目的分析外伤性脾破裂后行脾脏保留手术的临床效果及术后血清免疫球蛋白、Tuftsin因子水平变化。方法选取重庆市第十三人民医院和重庆嘉陵医院2013年1月至2016年12月收治的外伤性脾破裂患者90例作为研究对象,按照手术方式不同分为保留组和切除组各45例,其中保留组给予脾脏保留术,切除组给予开腹脾切除术。观察两组手术效果、免疫功能、免疫球蛋白水平、Tuftsin因子水平以及并发症发生情况。结果保留组手术时间、术中出血量、肛门排气时间、下床活动时间、住院时间显著低于切除组(P均<0.01);与术前相比,术后4周CD3^+、CD4^+、CD4^+/CD8^+水平保留组升高,切除组降低,且保留组显著高于切除组(P<0.05,P<0.01),CD8^+水平保留组降低,切除组升高,且保留组低于切除组(P<0.05,P<0.01);术后4周保留组Ig G、Ig A、Ig M及Tuftsin因子水平显著升高,切除组显著降低,且保留组显著高于切除组(P<0.05,P<0.01);保留组并发症发生率(8.89%)显著低于切除组(24.44%),差异有统计学意义(P<0.05)。结论外伤性脾破裂后行脾脏保留手术可有效改善患者T淋巴细胞和免疫球蛋白水平,降低并发症发生率。
Objective To analyze the clinical effect of spleen-preserving operation after traumatic splenic rupture and the changes of serum immunoglobulin and Tuftsin factor levels. Methods A total of 90 patients with traumatic splenic rupture admitted to the Chongqing Thirteenth People＇ s Hospital and Chongqing Jialing Hospital from January 2013 to December 2016 were selected as study objectsand divided into retention group（ spleen-preserving surgery） and resection group（ open splenectomy）（ n = 45,each）. Operation effect,immune function,levels of immunoglobulin and tuftsin factor,incidence of complications were observed between two groups. Results Operation time,intraoperative blood loss,anal exhaust time,ambulation time and hospital stay in retention group were significantly lower than those in resection group（ all P〈0. 01）. Compared with pre-operation,levels of CD3^＋,CD4^＋and CD4^＋/CD8^＋increased in retention group and decreased in resection group,and they were significantly higher in retention group than those in resection group at 4 weeks after operation（ P〈0. 05,P〈0. 01）; level of CD8^＋decreased in retention group and increased in resection group,and it was significantly lower in retention group than that in resection group at 4 weeks after operation（ P〈0. 05,P〈0. 01）.Compared with pre-operation,levels of IgG,IgA,IgM and Tuftsin factor increased significantly in retention group and decreased in resection group,and they were significantly higher in retention group than those in resection group at 4 weeks after operation（ P〈0. 05,P〈0. 01）. The complication rate in retention group was significantly lower than that in resection group（ 8. 89% vs 24. 44%,P〈0. 05）. Conclusion Spleen-preserving operation after traumatic splenic rupture can effectively increase T lymphocyte and immunoglobulin levels and reduce the incidence of complications in patients.
出处
《中国临床研究》
CAS
2018年第2期172-175,共4页
Chinese Journal of Clinical Research
基金
重庆市自然科学基金计划项目(csts2014jjA10061)
