腹腔镜胆囊切除术对患者术后免疫炎症反应指标的影响

The impact of laparoscopic cholecystectomy on the immune status and inflammation reaction of patients with gallstones

目的:分析腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)对术后患者免疫炎症反应指标的影响。方法:分析2013年1月至2015年1月收治的88例胆囊结石患者的临床资料,分为观察组(LC,n=46)与对照组(开腹胆囊切除术,n=42)。结果:观察组患者术中出血量、术后排气时间及术后并发症发生率均显著低于对照组,差异有统计学意义(P<0.05)。观察组术后CD4^+、CD8^+淋巴细胞及CD4^+/CD8^+水平均高于对照组(P<0.05)。观察组患者术后3 d CRP及TNF-α水平低于对照组差异有统计学意义(P<0.05)。结论:与传统开腹手术相比,LC可显著降低患者术后免疫炎症反应程度,提高总体疗效。

Objective：The study was aimed to analyze the impact of laparoscopic cholecystectomy on the immune status and inflammation reaction of patients with gallstones.Methods：Clinical data of patients with gallstones from Jan.2013 to Jan.2015 were analyzed.Patients were divided into two groups,the patients who underwent laparoscopic cholecystectomy were selected as Group A（n=46）;the patients who underwent open cholecystectomy were selected as Group B（n=42）.Results：Blood loss during operation,postoperative exhaust time and rate of complications of Group A were lower than those of Group B patients,the differences were statistically significant（P〈0. 05）.In 3 days after surgery,patients in Group A had higher levels of CD4-＋,CD8-＋ lymph cell and CD4-＋/CD8-＋than those in Group B,the difference was statistically significant（P〈0. 05）.After surgery,patients of Group A had lower levels of CRP and TNF-α than patients of Group B,the difference was statistically significant（P〈0. 05）.Conclusions：Compared with traditional open surgery,laparoscopic cholecystectomy for gallstones is more efficient with a lower postoperative immunosuppression and stress response.