胆囊切除术所致医源性胆道损伤对机体的影响

Influence of iatrogenic bile duct injury to the body caused by cholecystectomy

目的探究胆囊切除术所致医源性胆道损伤对机体的影响。方法选择于我院接受治疗的20例医源性胆道损伤患者,均为胆囊切除术所致。记录全部患者损伤类型及部位,测定并比较手术前后免疫指标、炎症指标、肝功能指标。结果手术前患者的Ig A、Ig G、Ig M指标测定值分别为(1.23±0.31)g/L,(8.27±0.53)g/L和(1.05±0.25)g/L,显著低于手术后的(1.36±0.33)g/L、(13.02±0.73)g/L和(1.37±0.34)g/L(P<0.05)。手术前患者IL-6、IL-10、CRP炎症指标分别为(3.5±0.8)ng/L,(2.7±0.4)ng/L,(16.4±9.2)ng/L,显著低于手术后的(15.8±0.7)ng/L,(40.6±8.9)ng/L,(65.3±14.7)ng/L(P<0.05)。手术后患者ALT、ALP、AST、TBIL及DBIL测定值,均显著高于手术前(P<0.05)。结论胆囊切除术所致医源性胆道损伤可降低患者免疫功能与肝功能,促进炎症反应。

Objective To explore the influence of iatrogenic bile duct injury to the body caused by cholecystectomy. Methods Twenty cases of patients with iatrogenic bile duct injury who receive cholecystectomy in our hospital were selected as study objects. The injury types and locations were recorded, and the immune indexes, inflammation index, liver function index were measured and compared before and after surgery. Results The values of IgA, IgG, IgM before the surgery were （1.23±0.31）g/L, （8.27±0.53）g/L （1.05±0.25）g/L respectively, which were obviously lower than （1.36±0.33）g/L, （13.02±0.73）g/L and （1.37±0.34） g/L after the surgery （P〈0.05）. The levels of IL-6, IL-10, CRP before the surgery were （3.5±0.8） ng/L, （2.7±0.4） ng/L, （16.4±9.2） ng/L respectively, which were obviously lower than （15.8±0.7） ng/L, （40.6±8.9） ng/L, （65.3±14.7） ng/L after the surgery （P〈0.05）. The levels of ALT, ALP, AST, TBIL, DBIL after the surgery were significantly higher than those before the surgery （P〈0.05）. Conclusion Iatrogenic bile duct injury caused by cholecystectomy can reduce the patients＇ immune function and liver function, also can promote inflammation.