腹腔镜与开腹胆囊切除术对老年胆囊结石患者T细胞亚群、CRP和ALT水平影响的对比研究

Influence of laparoscopy and open cholecystectomy on T-lymphocyte subpopulation and CRP of elderly patients with cholecystolithiasis

目的探讨腹腔镜胆囊切除术(Laparoscopy Cholecystectomy,LC)与开腹胆囊切除术(Open Cholecystectomy,OC)对老年胆囊结石患者T细胞亚群、C反应蛋白(CRP)及丙氨酸氨基转移酶(ALT)水平的影响。方法选取我院2012年2月至2015年3月收治的98例老年胆囊结石患者作为研究对象,随机分为实验组和对照组,实验组(n=52例)实施腹腔镜胆囊切除术,对照组(n=46例)实施开腹胆囊切除术,比较两组手术前后患者T细胞亚群(CD3^+、CD4^+、CD8^+细胞)、C反应蛋白(CRP)及丙氨酸氨基转移酶(ALT)水平的变化情况。结果术前,两组患者的相关免疫细胞、CRP及ALT指标无统计学差异(P>0.05),术后组间不同时间点三项指标比较有统计学差异(P<0.05);术前术后两组患者相关免疫细胞、CRP及ALT指标变化趋势相同,组内不同时间点三项指标比较有统计学差异(P<0.05),实验组恢复较快。结论与开腹胆囊切除术相比较,腹腔镜胆囊切除术对老年患者机体的不良刺激较小,对免疫功能及肝功能的影响无显著差异,是一种安全可靠的手术方式。

Objective To discuss the effect of laparoscopy and open cholecystectomy on the level of CD;CRP and ALT of elderly patients with cholecystolithiasis. Methods 98 cases of patients with cholecystolithiasis in our hospital from January 2013 to January 2015 were selected and randomly divided into experiment group（ 52cases） and control group（ 46 cases）. The experiment group was treated with laparoscopy cholecystectomy and the control group was treated with open cholecystectomy; then the change of CD; CRP and ALT before and after the operation were compared in two group. Results The two groups before operation in patients with CD,CRP and ALT were not statistically significant（ P〈0. 05）,differences between the two groups at different time points were statistically significant（ P〈0. 05） after operation; CD,CRP and ALT changing trend in the two groups were the same,differences in the two groups were statistically significant（ P〈0. 05）,but the experimental group resumed faster than the control group. Conclusions Compared with open cholecystectomy,laparoscopy cholecystectomy brings less pessimal stimulation to the body,and decline impact on immune and liver function,thus is safe and feasible,have application prospects.