中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
26期
8-10
,共3页
输血,自体%细胞免疫%骨科手术
輸血,自體%細胞免疫%骨科手術
수혈,자체%세포면역%골과수술
Blood transfusion,autologous%Cell immunity%Orthopedic operation
目的 探讨自体血回输对骨科手术患者围手术期细胞免疫功能的影响.方法 回顾性分析2007年6月至2011年10月择期骨科手术患者226例的临床资料,根据输血方式分为观察组(154例)和对照组(72例).观察组术中采用血液回收机将自体血回输给患者,对照组术中全部输异体成分血,分别于人手术室(术前),术后第1、6天检测两组患者静脉血T淋巴细胞亚群和自然杀伤细胞(NK细胞)并进行统计学分析.结果 观察组和对照组术后第1天CD3+、CD4+、CD4+/CD8+、NK细胞分别为0.7184±0.0921、0.3878±0.0611、1.64±0.27、0.1627±0.0633和0.6548±0.0852、0.3137±0.0726、1.18±0.31、0.1465±0.0514,均较术前的0.7436±0.1069、0.4301±0.0818、1.68±0.31、0.1945±0.0572和0.7537±0.0940、0.4453±0.0608、1.62±0.32、0.1821±0.0571明显减少(P＜0.05),但观察组明显高于对照组,差异有统计学意义(P＜0.05).术后第6天观察组CD3+、CD4+、CD4+/CD8+、NK细胞与术前比较差异无统计学意义(P＞0.05)；而对照组术后第6天CD3+、CD4+、CD4+/CD8+、NK细胞分别为0.6266±0.0905、0.3048±0.0425、1.07±0.27、0.1408±0.0716,仍较术前明显减少,差异有统计学意义(P＜ 0.05).结论 术后自体血回输患者细胞免疫功能的抑制较异体血输入者轻,术后细胞免疫功能恢复快.
目的 探討自體血迴輸對骨科手術患者圍手術期細胞免疫功能的影響.方法 迴顧性分析2007年6月至2011年10月擇期骨科手術患者226例的臨床資料,根據輸血方式分為觀察組(154例)和對照組(72例).觀察組術中採用血液迴收機將自體血迴輸給患者,對照組術中全部輸異體成分血,分彆于人手術室(術前),術後第1、6天檢測兩組患者靜脈血T淋巴細胞亞群和自然殺傷細胞(NK細胞)併進行統計學分析.結果 觀察組和對照組術後第1天CD3+、CD4+、CD4+/CD8+、NK細胞分彆為0.7184±0.0921、0.3878±0.0611、1.64±0.27、0.1627±0.0633和0.6548±0.0852、0.3137±0.0726、1.18±0.31、0.1465±0.0514,均較術前的0.7436±0.1069、0.4301±0.0818、1.68±0.31、0.1945±0.0572和0.7537±0.0940、0.4453±0.0608、1.62±0.32、0.1821±0.0571明顯減少(P＜0.05),但觀察組明顯高于對照組,差異有統計學意義(P＜0.05).術後第6天觀察組CD3+、CD4+、CD4+/CD8+、NK細胞與術前比較差異無統計學意義(P＞0.05)；而對照組術後第6天CD3+、CD4+、CD4+/CD8+、NK細胞分彆為0.6266±0.0905、0.3048±0.0425、1.07±0.27、0.1408±0.0716,仍較術前明顯減少,差異有統計學意義(P＜ 0.05).結論 術後自體血迴輸患者細胞免疫功能的抑製較異體血輸入者輕,術後細胞免疫功能恢複快.
목적 탐토자체혈회수대골과수술환자위수술기세포면역공능적영향.방법 회고성분석2007년6월지2011년10월택기골과수술환자226례적림상자료,근거수혈방식분위관찰조(154례)화대조조(72례).관찰조술중채용혈액회수궤장자체혈회수급환자,대조조술중전부수이체성분혈,분별우인수술실(술전),술후제1、6천검측량조환자정맥혈T림파세포아군화자연살상세포(NK세포)병진행통계학분석.결과 관찰조화대조조술후제1천CD3+、CD4+、CD4+/CD8+、NK세포분별위0.7184±0.0921、0.3878±0.0611、1.64±0.27、0.1627±0.0633화0.6548±0.0852、0.3137±0.0726、1.18±0.31、0.1465±0.0514,균교술전적0.7436±0.1069、0.4301±0.0818、1.68±0.31、0.1945±0.0572화0.7537±0.0940、0.4453±0.0608、1.62±0.32、0.1821±0.0571명현감소(P＜0.05),단관찰조명현고우대조조,차이유통계학의의(P＜0.05).술후제6천관찰조CD3+、CD4+、CD4+/CD8+、NK세포여술전비교차이무통계학의의(P＞0.05)；이대조조술후제6천CD3+、CD4+、CD4+/CD8+、NK세포분별위0.6266±0.0905、0.3048±0.0425、1.07±0.27、0.1408±0.0716,잉교술전명현감소,차이유통계학의의(P＜ 0.05).결론 술후자체혈회수환자세포면역공능적억제교이체혈수입자경,술후세포면역공능회복쾌.
Objective To explore the effect of autologous blood transfusion on cytoimmunity during orthopedic operation.Methods Two hundred and twenty-six patients undertaken selective operation from June 2007 to October 2011 were divided into observation group ( 154 cases) and control group (72 cases).The observation group was received autologous blood transfusion and the control group was given homologous transfusion.T lymphocyte subsets and natural killer (NK) cell counts in blood samples were detected by flow cytometry before operation and 1,6 days after operation.Results CD3+,CD4+,CD4+/CD8+,NK cell of the observation group and control group on 1st day of postoperation were 0.7184 ±0.0921,0.3878 ±0.0611,1.64 ± 0.27,0.1627 ± 0.0633 and 0.6548 ± 0.0852,0.3137 ± 0.0726,1.18 ± 0.31,0.1465 ± 0.0514,respectively,which decreased obviously compared with those of preoperation in both groups (0.7436 ± 0.1069,0.4301 ±0.0818,1.68 ±0.31,0.1945 ±0.0572 and 0.7537 ±0.0940,0.4453 ±0.0608,1.62 ± 0.32,0.1821 ± 0.0571 ) (P ＜ 0.05 ).The above parameters of the observation group were significandy higher than those of the control group on 1 st day of postoperation (P ＜ 0.05 ).There were no significant differences of CD3+,CD4+,CD4+/CD8+ and NK cell on the 6th day of postoperation compared with the preoperation in the observation group (P ＞ 0.05).But CD3+,CD4+,CD4+/CDs+ and NK cell on the 6th day of the postoperation were 0.6266 ± 0.0905,0.3048 ± 0.0425,1.07 ± 0.27,0.1408 ± 0.0716,which were significantly lower than the preoperation in the control group (P ＜ 0.05).Conclusions Intraoperative autologous blood transfusion have less inhibitory effect on cytoimmunity than homologous transfusion.The patients having autologous blood transfusion have a rapid recovery of cytoimmunity.
