Effects of laparoscopic splenectomy and esophagogastric devascularization on stress and immune function in patients with cirrhotic portal hypertension
10.3760/cma.j.issn.1007-631X.2019.07.016
- VernacularTitle:腹腔镜脾切除贲门周围血管离断术对肝硬化门静脉高压症患者应激和免疫功能的影响
- Author:
Kunfu DAI
1
;
Shuai MA
;
Xiaopei HAO
;
Yuting HE
;
Tao ZHOU
;
Guangjin TIAN
;
Yadong DONG
;
Haibo YU
Author Information
1. 河南大学河南省人民医院肝胆胰腺外科
- Keywords:
Hypertension,portal;
Hydrocortisone;
T-lymphocytes subsets;
Splenectomy
- From:
Chinese Journal of General Surgery
2019;34(7):609-612
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effects of laparoscopic splenectomy and esophagogastric devascularization(LSPD) vs.open procedure(OSPD) on stress and immune function in patients with portal hypertension due to cirrhosis.Methods From June 2015 to June 2017 a total of 66 patients underwent LSPD or OSPD procedures.Results Plasma cortisol concentration in the LSPD group was lower than that in the OSPD group (Fgroup =18.85,P =0.020).Cortisol concentration in the two groups increased firstly and then decreased with time extension (Ftime =532.08,P =0.000).The level of CD3 +,CD4 +,CD4 +/CD8 + in LSPD group was higher than that in OSPD group,and the level of CD8 + was lower than that in OSPD group (Fgroup =3.55,21.47,154.84,64.29,P ＜ 0.05),the levels of CD3 +,CD4 + and CD4 +/CD8 + in the two groups first decreased and then increased with the extension of time,and the levels of CD8 + increased firstly and then decreased (Ftime =199.22,298.48,864.33,510.23,P ＜ 0.05),the increase range of CD3 +,CD4 +,and CD4 +/CD8 + in LSED group was higher than that in OSPD group (Finteraction =19.27,18.21,79.55,35.21,P ＜ 0.05);there was no statistical significance in the complications such as:rebleeding,thrombosis and splenic fever in the two groups (x2 =0.05,0.67,0.07,0.16,P=0.829,0.413,0.789,0.693).But the postoperative chest/cavity effusion and fever (＞ 38.0 ℃,and ＞ 3 days) is OSPD group is higher than in the LSPD group(x2 =5.49,6.68,P =0.019,0.010).Conclusion LSPD effectively reduces postoperative stress,protects immune function,decreases postoperative pleural and abdominal effusion and fever.
