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首页> 外文期刊>BMC Surgery >Effect of emergency major abdominal surgery on CD4 cell count among HIV positive patients in a sub Saharan Africa tertiary hospital - a prospective study
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Effect of emergency major abdominal surgery on CD4 cell count among HIV positive patients in a sub Saharan Africa tertiary hospital - a prospective study

机译：紧急大腹部手术对撒哈拉以南非洲三级医院HIV阳性患者CD4细胞计数的影响-前瞻性研究

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Background Surgery plays a key role in HIV palliative care, specifically in the diagnosis and treatment of HIV related and non-related conditions. Yet major surgery depresses the immune system. Whereas the surgical consequences of HIV infection are well described, there is a paucity of published data, in resource-limited settings, on the effects of major surgery on the immune system. The purpose of this study was to determine the effect of major abdominal surgery on CD4 count in HIV positive and HIV negative patients after emergency major surgery. Methods A prospective cohort study was done for patients who underwent emergency major abdominal surgery. Their peri-operative CD4 counts were done for both HIV- and HIV?+?patients. Median CD4s were used in analysis. Mann Whitney test of significance was used for continuous data and Fisher’ exact test used for categorical data. IRB approval was obtained. Results A total of 101 patients were recruited, 25 HIV positive and 76 HIV negative. The median CD4 cell reduction was higher in the HIV negative group (?68 cells) than HIV positive group (?29 cells) (p?=?0.480). There was a general increase in the median CD4 change by 72 cells for the HIV positives and 95 cells for the HIV negatives (p?=?0.44). CD4 change rose in both the HIV positive and negative groups by 27 cells for the HIV positives and 28 cells for the HIV negatives (p?=?0.94). Relative Risk was 0.96, {CI 0.60 – 1.53}. Conclusion Major emergency abdominal surgery had no significant effect on CD4 cell count among HIV positive patients.
机译：背景外科手术在HIV姑息治疗中起着关键作用，特别是在HIV相关和非相关疾病的诊断和治疗中。然而大手术压低了免疫系统。尽管已经充分描述了HIV感染的手术后果，但在资源有限的情况下，关于大手术对免疫系统影响的公开数据很少。这项研究的目的是确定紧急大手术后大腹部手术对HIV阳性和HIV阴性患者CD4计数的影响。方法对接受紧急大腹部手术的患者进行前瞻性队列研究。他们的围手术期CD4计数是针对HIV和HIV？+？患者进行的。中位数CD4用于分析。连续数据使用Mann Whitney的显着性检验，分类数据使用Fisher的精确检验。已获得IRB的批准。结果共招募101例患者，其中HIV阳性25例，HIV阴性76例。 HIV阴性组（〜68个细胞）的中值CD4细胞减少高于HIV阳性组（〜29个细胞）（p ＝ 0.480）。 HIV阳性的中位数CD4变化普遍增加72个细胞，HIV阴性的中位数CD4变化增加95个细胞（p≥0.44）。 HIV阳性和阴性组的CD4变化上升，其中HIV阳性的细胞为27个细胞，而HIV阴性的细胞为28个细胞（p ＝ 0.94）。相对风险为0.96，{CI 0.60 – 1.53}。结论重大的紧急腹部手术对HIV阳性患者的CD4细胞计数无明显影响。

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