关键词: 免疫反应, 围手术期, 感染, 免疫功能障碍, 手术损伤

Abstract:

Immune dysfunction and perioperative infection                         MAO En-qiang，CHEN Ying. Department of Emergency， Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025，China
Corresponding author：MAO En-qiang，E-mail：maoeq@yeah.net
Abstract    The primary disease and surgery may lead to multiple strikes on immune function, which contributes to higher perioperative infection rate, patient morbidity and mortality. Nonspecific immune response, cell-mediated immune response and antibody mediated humoral immune response could be affected by the basic health status such as aging, malnutrition，obesity，diabetes，cancer and the bad habits for example smoking and alcohol，leading to immune dysfunction，which increases the risk of perioperative infection. The clinical and basic researches showed that a serial complicated pathophysiologic changes on hemodynamics, metabolism, and nerve-endocrine system is caused by the surgery stress damage. It release a large numbers of pro-inflammatory mediators resulting in systemic inflammatory response syndrome，and initiate compensatory anti-inflammatory response syndrome at the same time, which leads to temporary immune dysfunction after trauma or surgery，triggering secondary perioperative infections. To reduce perioperative infection relies on combined interventions due to the interacts among the primary disease，basic condition and surgical trauma.

Key words: immune response, perioperative period, infection, immune dysfunction, surgery damage