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目的 观察开腹手术和腹腔镜不同气腹环境对大鼠系统免疫功能的影响。方法 将 6 0只雌性S-D大鼠随机分为 4组 :开腹组 ;CO2 气腹组 ;无气组 ;N2 气腹组 ,每组 15只。模拟开腹手术和相应腹腔镜手术时的气腹环境 ,时间为 1h。分别于手术第 0、1、3、7d检测大鼠血液中CD3 、CD4和CDRT细胞的数值变化 ,了解开腹及不同气腹对大鼠系统免疫功能的影响。结果 术后各组CD细胞计数值均明显下降 (P <0 .0 0 1) ,开腹组最低 (P <0 .0 0 1) ;CO2 气腹组居中 (P <0 .0 0 1) ,无气和N2 组间无统计学差异 (P >0 .0 5 ) ,免疫抑制程度最低。开腹组术后恢复最慢 (P <0 .0 1) ;CO2 气腹组居中 (P <0 .0 1) ,无气和N2 气腹组数值基本相同 (P >0 .0 5 ) ,恢复最快。第 7d各组印细胞计数均恢复术前正常水平 (P >0 .0 5 )。结论 CO2 气腹对系统免疫功能抑制程度小于开腹组 ,但大于无气或N2 气腹组 ,术后恢复晚于后两组。
Objective To observe the effects of laparotomy and laparoscopic pneumoperitoneum on immune system in rats. Methods Sixty female S-D rats were randomly divided into 4 groups: laparotomy group, CO2 pneumoperitoneum group, no gas group and N2 pneumoperitoneum group, 15 rats in each group. Simulate laparotomy and laparoscopic pneumoperitoneum environment, the time was 1h. The changes of CD3, CD4 and CDRT in blood of rats were detected on the 0, 1, 3, 7 days after operation respectively to investigate the effects of laparotomy and different pneumoperitoneum on the immune function of rats. Results The counts of CD cells in each group were significantly decreased (P <0. 001), lowest in the open group (P <0. 001), and moderate in the CO2 pneumoperitoneum group (P <0.01) , No gas and no significant difference between N2 group (P> 0.05), the lowest degree of immunosuppression. The laparotomy group had the slowest recovery after operation (P <0.01), CO2 pneumoperitoneum group (P <0.01), and no gas and N2 pneumoperitoneum group (P> 0.05) Recovery fastest. On the 7th day, the number of each cell in each group recovered to the normal level before operation (P> 0.05). Conclusion CO2 pneumoperitoneum has less inhibitory effect on the immune system than the laparotomy group but larger than the pneumoperitoneum group or N2 pneumoperitoneum group and the postoperative recovery is later than the latter two groups.