遥控Zeus手术机器人与腹腔镜胆囊切除术后免疫功能的比较

Comparison of postoperative immune function of patients undergoing Zeus robot-assisted laparoscopic cholecystectomy and laparoscopic cholecystectomy

目的比较遥控Zeus手术机器人胆囊切除术(RLC)与常规腹腔镜胆囊切除术(CLC)对患者术后免疫功能的影响。方法收集1年内诊治的胆囊结石、胆囊息肉患者5 2例的临床资料,其中行RLC 2 3例,CLC 2 9例。对两组手术前后免疫功能指标如T细胞亚群,IgA,IgM,IgG及补体C 3和C 4的变化进行比较。两组手术均顺利完成。结果RLC手术前后CD 4/CD 8分别为1.5 6±0.6 7和1.3 0±0.5 3,IgM分别为1.4 2±0.5 8和1.2 6±0.4 6,术后均有显著下降(P<0.0 5)。CLC手术后C 3从1.4 8±0.3 4下降至1.3 8±0.2 8,C 4则从0.2 5±0.0 9下降至0.2 2±0.0 7,差异有统计学(P<0.0 5)。两种手术方式手术前后所测定的其他免疫指标均无明显差异(P>0.0 5),且两组间差异无显著性(P>0.0 5)。结论RLC与CLC对患者术后细胞免疫功能的影响均不明显;但均对体液免疫功能有一定影响。

Objective To compare the postoperative changes in immune function of patients undergoing robot-assisted laparoscopic cholecystectomy （RLC） and conventional laparoscopic cholecystectomy （CLC）. Methods The clinical data of 52 cases of gallbladder stones and gallbladder polyps treated with RLC （23 cases ）, and with LC （29 cases ） was compared. Blood samples from both groups were taken to measure immune markers （T cells, IgA, IgM, IgG, C3, C4 ） before operation and in the first postoperative morning. Results The postoperative levels of CD4/CD8 and IgM decreased from 1.56 ± 0.67, 1.42 ± 0.58 to 1.30±0. 53, 1. 26 ±0.46 respectively after RLC（all P 〈0. 05）. C3 and C4 after CLC decreased from 1.48 ±0. 34, 0. 25 ±0. 09 to 1. 38 ±0. 28, 0. 22 ±0. 07 respectively（all P 〈 0.05 ）. But the levels of immune markers before and after operation were not significantly different between RLC and CLC groups （ P 〉 0.05 ）. Conclusions RLC and CLC showed no significant postoperative effect on cellular immune function, but both had some effect on humoral immune function.