文章摘要

腹腔镜Ladd手术对肠旋转不良患儿的有效性及患儿血清T细胞亚群水平的影响

作者: 1姚远
1 西安市儿童医院普外一科,西安 710003
通讯: 姚远 Email: yaoyuan_xb@yeah.net
DOI: 10.3978/j.issn.2095-6959.2020.10.017

摘要

目的:探讨腹腔镜Ladd手术对肠旋转不良患儿的有效性及对患儿血清T细胞亚群水平的影响。方法:将65例西安市儿童医院收治的肠旋转不良患儿随机分为腹腔镜组与对照组。对照组患儿接受传统开腹Ladd手术,腹腔镜组患儿接受腹腔镜Ladd手术。比较两组患儿手术时间、术中出血量、术后肛门排气时间及住院时间;比较两组患儿手术前、手术24 h后及手术5 d后外周血T细胞亚群水平和NK细胞水平;比较两组患儿术后并发症的发生情况。结果:腹腔镜组患儿手术时间长于对照组患儿(P<0.05),术中出血量、术后肛门排气时间及住院时间均少于对照组患儿(均P<0.05);手术24 h后,腹腔镜组患儿血清CD3+,CD4+,CD4+/CD8+及NK细胞水平均高于对照组患儿(均P<0.05),CD8+水平低于对照组患儿(P<0.05);手术5 d后,腹腔镜组患儿血清CD4+,CD4+/CD8+及NK细胞水平均高于对照组患儿(均P<0.05),CD8+水平低于对照组患儿(P<0.05);腹腔镜组患儿并发症总发生率(3.1%)低于对照组患儿(24.2%),(P<0.05)。结论:腹腔镜Ladd手术对肠旋转不良患儿具有一定疗效且创伤小,对患儿的免疫抑制作用较轻,患儿恢复较快且并发症发生率较低。
关键词: 腹腔镜;Ladd手术;肠旋转不良;T细胞亚群

Effect of laparoscopic Ladd surgery in children with intestinal malrotation and its effect on serum T cell subsets

Authors: 1YAO Yuan
1 Section 1 of General Surgery Department, Xi’an Children’s Hospital, Xi’an 710003, China

CorrespondingAuthor: YAO Yuan Email: yaoyuan_xb@yeah.net

Abstract

Objective: To explore the effect of laparoscopic Ladd surgery in children with intestinal malrotation and its effect on serum T cell subsets. Methods: A total of 65 children with intestinal malrotation were randomly divided into a laparoscopy group and a control group. Children in the control group were received conventional open Ladd surgery, while the others in the laparoscopic group were received laparoscopic Ladd surgery. The operative time, intraoperative blood loss volume, postoperative anal exhaust time, and hospitalization time were then compared between the two groups. The levels of T cell subsets and NK cells in peripheral blood of the 2 groups were compared before the surgery, 24 h after the surgery and 5 d after the surgery. The incidence of postoperative complications was compared between the 2 groups. Results: The operation time of children in the laparoscopic group was longer than that in the control group (P<0.05), and the intraoperative blood loss volume, postoperative anal exhaust time, and hospitalization time were all less than those in the control group (all P<0.05). The serum levels of CD3+, CD4+, CD4+/CD8+ and NK cells in the laparoscopic group were all higher than those in the control group (all P<0.05), and the level of CD8+ in the laparoscopic group was lower than that in the control group (P<0.05) 24 h after the surgery. The serum levels of CD4+, CD4+/CD8+ and NK cells in the laparoscopic group were all higher than those in the control group (P<0.05), and the level of CD8+ in the laparoscopic group was lower than that in the control group (P<0.05) 5 d after the surgery. The total incidence of complications in the laparoscopic group (3.1%) was lower than that in the control group (24.2%), (P<0.05). Conclusion: Laparoscopic Ladd surgery has a certain curative effect but little trauma on children with intestinal malrotation, and has less immunosuppressive effect, faster recovery, and lower incidence of complications.
Keywords: laparoscopic; Ladd surgery; intestinal malrotation; T cell subsets