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目的:探讨超声刀(UAS)和电刀(E)l对乳癌改良根治术后免疫功能和应激的影响。方法:回顾性分析62例乳腺癌改良根治术患者资料,其中33例使用UAS,29例用El,比较2组淋巴结检出数、术后24h引流量、腋窝引流管留置时间、刀口拆线时间;应用流式细胞仪测定2组手术前后外周血中T淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+比率;术后第2天检测血粒细胞计数、粒细胞百分比、C-反应蛋白(CRP)、血糖。结果:UAS组与El组相比,淋巴结检出数,CD3+、CD4+、CD8+、CD4+/CD8+比率,血糖无明显差别(P>0.05);术后24h引流量、腋窝引流管留置时间、粒细胞计数、粒细胞百分比、CRP,UAS组较El组均有明显减少,且差异有统计学意义(P<0.05或P<0.01)。结论:2种器械在乳腺癌改良根治术中切除效果及对术后免疫功能影响无明显差异,但应用UAS术后恢复快且对术后应激反应小。
Objective: To investigate the effect of ultrasonic knife (UAS) and electric knife (E) l on immune function and stress after modified radical mastectomy for breast cancer. Methods: The data of 62 patients with modified radical mastectomy of breast cancer were retrospectively analyzed. Among them, 33 cases were treated with UAS, 29 cases were treated with El, the number of lymph nodes was compared in 2 groups, the amount of drainage after 24 hours, the indwelling time of axillary drainage tube, . The ratio of CD3 +, CD4 +, CD8 + and CD4 + / CD8 + of T lymphocyte subsets in peripheral blood was measured by flow cytometry before and after operation. The blood count, percentage of neutrophils, C-reactive protein CRP), blood sugar. Results: There was no significant difference in the number of lymph nodes, CD3 +, CD4 +, CD8 +, CD4 + / CD8 + ratio between UAS group and El group (P> 0.05) The counts, percentage of granulocytes, CRP, UAS group were significantly lower than El group, and the difference was statistically significant (P <0.05 or P <0.01). Conclusion: There is no significant difference between the two devices in modified radical mastectomy for breast cancer and the postoperative immune function. However, the recovery of UAS after operation is quick and the postoperative stress response is small.