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目的探讨经腹膜后腹腔镜手术(以下简称后腹腔镜手术)二氧化碳(CO2)气腹对机体免疫功能的影响,揭示机体在后腹腔镜CO2气腹刺激下的免疫应答反应。方法前瞻性研究20例患者在CO2气腹下行后腹腔镜手术,分别抽取手术前、手术开始45 min、术后第1 d和术后第3 d静脉血样本,观察样本中α-肿瘤坏死因子(TNFα)值的变化;并把同期10例腹膜后开放手术患者作为对照组。结果两组患者术前、手术开始45 min、手术后第1 d和手术后第3 d 4个时间点的实验数据,TNFα值的变化均为先下降,而后回升。后腹腔镜手术组术后第1 d降至最低,而开放手术组手术开始45 min降至最低值,此与后腹腔镜手术组有所不同,但总体趋势相仿,且上述变化组内及组间比较差异均无统计学意义。结论后腹腔镜手术TNFα值的变化很小,由此可以推断,后腹腔镜手术对机体免疫功能的影响较小。
Objective To investigate the effects of pneumoperitoneum (CO2) pneumoperitoneum on the immune function of patients after retroperitoneal laparoscopic surgery (hereinafter referred to as retroperitoneal laparoscopic surgery) and to reveal the immune response of the body under retroperitoneal laparoscopic CO2 pneumoperitoneum. Methods A prospective study of 20 patients undergoing pneumoperitoneum pneumoperitoneum laparoscopic surgery under pneumoperitoneum was performed. The venous blood samples were collected before operation, 45 min after operation, 1 d after operation and 3 d after operation. The α-tumor necrosis factor (TNFα) changes; and the same period in 10 cases of patients undergoing open retroperitoneal surgery as a control group. Results The data of two groups before operation, 45 min after operation, 4 days after operation on the first day and 3 days after operation, TNFα value both decreased and then rose. The laparoscopic surgery group was the lowest on the first postoperative day, while the lowest postoperatively in the open surgery group was 45 minutes after the operation, which was different from the retroperitoneal laparoscopic surgery group, but the overall trend was similar. There was no significant difference between the two groups. Conclusions The changes of TNFα in postoperative laparoscopic surgery are very small. It can be concluded that the effect of retroperitoneal laparoscopic surgery on immune function is small.