腹腔镜胆囊切除术及开腹胆囊切除术对机体不同应激反应的研究

Research of the different stress reaction induced by Laparoscopic cholecystectomy and Opening cholecystectomy

目的探讨比较腹腔镜胆囊切除术(LC)与开腹胆囊切除术(OC)两种不同手术方式,对机体应激反应的影响。方法前瞻性随机选择60例胆囊切除术患者,其中LC和OC均为30例。于手术当天清晨和术后24h分别抽取肘静脉血,测定中性粒细胞热休克蛋白70(HSP70)表达、血浆C-反应蛋白(CRP)和白细胞介素-6水平等进行了随机比较研究。结果中性粒细胞HSP70,血浆CRP及IL-6等指标水平在OC、LC组术后均高于术前,LC组术后水平均明显低于OC组术后,且发现LC和OC术后中性粒细胞HSP70表达与术后肠功能恢复时间及术后住院天数间均呈显著正相关。结论LC引发机体的急性期应激反应比OC所引发的机体急性期应激反应轻微。较轻的急性期应激反应可能是LC比OC术后恢复快的重要原因之一。

Objective To examine the different stress reaction induced by Laparoscopic cholecystectomy（LC） and Opening cholecystectomy （OC）. Methods 60 cases of patients who need cholecystectomy were selected, and the level of HSP 70 in leukocytes, the blood levels of CRP and IL--6 were measured in the morning of the operation and 24h later after operation, and indexes were researched through comparison. Results The level of HSP 70 in leukocytes, the blood levels of CRP and IL-6 were higher after operation than pre-operation in both OC group and LC group.Mter operation, the levels of these indexes were lower in LC group than OC group significantly. And the level of HSP 70 in leukocytes in both OC group and LC group were closely correlated with the time of the normal intestines function was recovered and with the days of in hospital. Conclu- sions The stress reaction induced by LC more severity than that induced by OC. The slight stress reaction of LC maybe is one of the important reason which would explain the better recovery of LC.