围手术期急性非等容量血液稀释对肿瘤患者术后免疫力及早期并发症的影响.pdfVIP

22 现代医院 2009 年6 月第 9 卷第 6 期 咆咱也执才也刻宵 Modem H叫iωJun 2C朋 Vol9 No6 罔手术期急性非等容量血液稀释对肿瘤患者术后免疫 刀及阜期并发症的影响 刘旺 EFFECT OF ACUTE NON -ISOVOLEMIC HEMEDILUTION ON EARLY COMPLlCATIONS IN PA丁IENTS UNDERGOING SURGERY uu -w;αng {摘 要] 目的探讨回手术期进行息性非等容i:血液稀稀(ANIH) 对肿瘤患者免疫功能以及早期并 且足症的影响。方法 选择ω例肿瘤患者分为 2 组，30 1Ji1 ANIH 组阁手术期进行 ANIH ， 30 例对照纽术前为常 规处理。所有患者稀释前、稀释后和术后 24h 用流式细胞仪测最 T 淋巴细胞:?.群( CD3 ， CD4， CD肘，并观察 他们早期并发症发生率。结果 稀释后 ANIH 纽与稀释前 CD3 ， CD4 T 淋巴细胞:?.群水平有2巨著位差异(p 0.0日，而稀释后 24h 与稀释前差异均不显著(p 0. 05);稀释后 ANIH 组与同时间段对照纽患者 CD3， CD4T 淋巴细胞:?.嚣羊水平是异显著(p 0. 05 )，而稀释前与稀释后 24h 与对照级1..并不.a著 (p 0. 05) 。不同时间 段或者不同组问 CD8 T 淋巴细胞筑群水平差异均不显著。稀释后 ANIH 组与对照纽患者相比，感染以及总并 且民症发生牟有显著性差异(p 0. 05) 。结论 回手术期进行 ANIH 可以提高肿痕患者 T 淋已知胞业群水平， 减少感染等早期并发症比率。 {提键词] 怠，除非等容量血浪稀稀肿瘤免疫 [ Abstract] 0时ective To 阳.dy the effect of acute non - isovolemic hemedilution on early complications in patients undergoing tumorectomy. Me伽创s 60 patients were divided into 2 伊Oup由 tωIntrol group ( n 坦 30) 刷.d acute non-is仰olemic hemedilution ( ANIH) group (n = 30) . The patients in control 伊.up were received routine 阳tment before operation and the patie附 in ANIH 伊up were proc悦ded by pr阳perative infusion of 15 ml/kg of 60 glL hydro巧呻yl starch( HES) I1t the rate of 50ml/min wi也 removí昭 blood (10% 阳 15% of the blo叫 amount in a 阴阳 tient) .咄e proportion of Iymphocyte subpopulation such as CD3 ? CD4 and CD8 were detected at 伽e time before 0严卧 tion ,l h after hemodilution and 24h after 也e operation in all patients. The early ∞mplic且tions were observed in all pa- tie脚 t∞.Rωults [ 1 ] In ANIH group. the proportion of CD3 and CD4 in patients before operation were lower 出m 出at in patients 8t 1 h after hemodilution (p O. 05) ,but were índifferent wi曲也8t in p8tients I1t 24 h after hemodilu帽 tion (p O. 05) ? [2] At 1 h after hemodilution , the proportion of CD3 and CD4 in patients in ANIH group were higher than that in oontrol group(p 0.05) ,But at the time before operation or at 24 h after hemodilution , this difference 刘旺:汕尾市人民医院广东汕尾 5166∞ ，喇帕