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目的:探讨后腹腔镜肾癌根治术对患者免疫功能的影响。方法:选择2013年5月-2015年5月在我院接受手术治疗的肾癌患者67例,根据手术方法不同分为研究组(37例)及对照组(30例)。研究组患者采用后腹腔镜肾癌根治术治疗,对照组患者采用传统开放手术治疗。观察并比较两组患者的手术时间、术中出血量、住院时间以及手术前后患者外周血T淋巴细胞亚群的变化情况。结果:研究组患者的手术时间、术中出血量及住院时间均少于对照组,差异具有统计学意义(P<0.05)。两组患者术前外周血T淋巴细胞CD3~+、CD4~+、CD8~+及CD4~+/CD8~+比较,差异无统计学意义(P>0.05);两组患者术后外周血T淋巴细胞CD3~+、CD4~+及CD4~+/CD8~+明显降低,但研究组高于对照组,差异具有统计学意义(P<0.05);两组患者术后CD8~+比较,差异无统计学意义(P>0.05)。结论:与传统开放手术相比较,后腹腔镜肾癌根治术对患者免疫功能的影响较小,手术时间短,术中出血量少,临床疗效显著,值得推广及应用。
Objective: To investigate the effect of retroperitoneal laparoscopic radical nephrectomy on immune function in patients. Methods: 67 patients with renal cell carcinoma who underwent surgery in our hospital from May 2013 to May 2015 were divided into study group (37 cases) and control group (30 cases) according to different surgical methods. The study group was treated with retroperitoneal laparoscopic radical nephrectomy and the control group with conventional open surgery. The operation time, intraoperative blood loss, hospital stay and changes of T lymphocyte subsets in peripheral blood of patients before and after operation were observed and compared. Results: The operation time, intraoperative blood loss and hospital stay of the study group were less than those of the control group, with statistical significance (P <0.05). There were no significant differences in the levels of CD3 ~ +, CD4 ~ +, CD8 ~ + and CD4 ~ + / CD8 ~ + between preoperative and postoperative peripheral blood T lymphocytes in both groups (P> 0.05) The levels of CD3 ~ +, CD4 ~ + and CD4 ~ + / CD8 ~ + in lymphocytes in the study group were significantly lower than those in the control group (P <0.05). The difference of CD8 + No statistical significance (P> 0.05). Conclusion: Compared with traditional open surgery, retroperitoneal laparoscopic radical nephrectomy has less impact on immune function, shorter operation time, less intraoperative blood loss and significant clinical curative effect, which deserves promotion and application.