| 非气管插管胸腔镜手术对体液免疫的影响 |
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| 引用本文： | 漆奋强,吴根社,向敏峰,袁天柱. 非气管插管胸腔镜手术对体液免疫的影响[J]. 中华全科医学, 2019, 17(4): 551-553. DOI: 10.16766/j.cnki.issn.1674-4152.000731 |
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| 作者姓名： | 漆奋强 吴根社 向敏峰 袁天柱 |
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| 作者单位： | 1. 广西医科大学第四附属医院心胸外科, 广西 柳州 545005; |
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| 基金项目： | 广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z2015153，Z20170910)；柳州市科学研究与技术开发计划课题(2015J030514) |
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| 摘 要： | 目的通过非气管插管和气管插管下胸腔镜手术对体液免疫影响的比较,了解非气管插管胸腔镜手术的免疫优势。方法将2015年1月—2017年5月间在广西医科大学第四附属医院行胸腔镜手术的患者118例根据知情选择分成非气管插管麻醉组(48例)和气管插管麻醉组(70例),比较2组患者术前1天及术后第1天、第3天和第7天免疫球蛋白IgG、IgM、IgA及补体C3、C4和CRP水平的差异。分别于术前1天及术后第1天、第3天和第7天的清晨7时采集患者肘前外周血10 mL并即刻送检。通过免疫悬浊计测定IgG、IgM、IgA及补体C3、C4和C反应蛋白(CRP),检测所采用的试剂盒均由上海复星长征医学科学有限公司提供。数据采用SPSS 18.0统计软件进行统计处理,以P<0.05为差异有统计学意义。结果术后,除CRP水平升高外,其他指标均有不同程度的降低。术后1、3、7 d,2组患者IgA、IgG、补体C3、C4比较,t值分别为1.746、 0.899、1.342、1.775、1.440、1.779、0.192、0.633、0.242、0.931、0.996、0.741,差异均无统计学意义(均P>0.05);术后1、3 d,非气管插管下胸腔镜组IgM水平显著高于气管插管下胸腔镜组,t值为2.868和2.930(P<0.05);术后1、3 d,非气管插管下胸腔镜组CRP水平显著低于气管插管下胸腔镜组,t值为4.952和3.271(P<0.05)。结论与气管插管下胸腔镜手术相比,非气管插管下胸腔镜手术更具有体液免疫的优势。
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| 关 键 词： | 非气管插管 胸腔镜 体液免疫 |
| 收稿时间： | 2018-02-26 |
Impact of non-tracheal intubation video-assisted thoracoscopic surgery on humoral immune response |
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| Affiliation: | Department of Cardiothoracic Surgery, the Forth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi 545005, China |
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| Abstract: | Objective To understand the immune advantages of non-tracheal intubation video-assisted thoracoscopic surgery (VATS) by comparing with influence of tracheal intubation for VATS on the humoral immunity. Methods Between January 2015 to May 2017, 118 patients undergoing VATS in our hospital were assigned into two groups according to non-tracheal intubation anesthesia group (group A, n=48) and tracheal intubation anesthesia group (group B, n=70) according to the patient's informed choice. Ten mL of peripheral blood was prepared at 1 day before the surgery, and 1 day, 3 days and 7 days after the surgery for the measurement of IgA, IgG, IgM, CRP, C3 and C4 by using immunoturbidimetric assay. The results between the two groups were compared by using SPSS 18.0 for statistical data processing and statistical analysis. P<0.05 was considered to be statistically significant. Results After the operation, the levels of all the immunoprotein reduced in different degree, except for CRP. There were no significance on IgA, IgG, C3, C4 level between the two groups on D1, D3 and D7 (all P>0.05, t=1.746, 0.899, 1.342, 1.775, 1.440, 1.779, 0.192, 0.633, 0.242, 0.931, 0.996, 0.741, respectively). The level of IgM on D1 and D3 after the surgery in the non-tracheal intubation anesthesia group was significantly higher than that in tracheal intubation anesthesia group (P<0.05, t=2.868, 2.930), however, the level of CRP in the non-tracheal intubation anesthesia group was significantly lower than that tracheal intubation anesthesia group (P<0.05, t=4.952, 3.271). Conclusion When compared with tracheal intubation anesthesia, non-tracheal intubation VATS can decrease the postoperative humoral immune response. |
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| Keywords: | Non-tracheal intubation anesthetic technique Videothoracoscopy Humoral immune response |
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