腹腔镜胆囊切除术对机体应激反应的影响

Effect of laparoscopic cholecystectomy on systemic stress response

目的 研究腹腔镜胆囊切除术对机体应激反应的影响。方法 将 70例胆囊炎、胆囊结石患者随机分成腹腔镜胆囊切除组 (LC)和开腹胆囊切除组 (OC)。术前和术后第 1,3,5 ,7d采集外周静脉血 ,测定白细胞介素 1β(IL 1β) ,肿瘤坏死因子α(TNF α) ,白细胞介素 6(IL 6 )和C 反应蛋白 (CRP)。结果 两组手术前后IL 1β和TNF α均无明显差异 (P >0 0 5 ) ,两组间手术前后比较也无明显差异 (P >0 0 5 ) ;两组手术后IL 6第 1d升至最高 ,与术前及术后第 3,5 ,7d比较有高度显著差异 (P <0 0 1)而术前与术后第 3,5 ,7d比较无显著差异 (P >0 0 5 ) ,两组之间比较亦无显著差异 (P >0 0 5 ) ;两组手术后CRP第 1,3,5d均较术前有明显升高 (P <0 0 5 ) ,以术后第 1和第 3d升高最明显 ,而两组之间比较无显著差异 (P >0 0 5 )。结论 LC对机体应激反应与OC相比没有明显差异。

Objective To investigate the systemic stress responses of laparoscopic cholecystectomy(LC). Methods Seventy patients with cholecystolithiasis were randomly divided into two groups: LC and open cholecystectomy(OC). Peripheral blood samples were obtained during the preoperative day and 1, 3, 5, 7 day after operation. Serum cytokines levels (TNF α, IL 1β and IL 6) and C reactive protein(CRP) were measured. Results Changes of TNF α and IL 1β before or after surgery in both groups showed no significant difference(P>0.05). Serum concentrations of IL 6 and CRP after surgery in both groups were significantly higher than those before surgery(P<0.05); but there were no significant difference between the two groups(P>0.05). Conclusions The systemic stress responses of LC have no significant difference comparing with OC.