腹腔镜与开腹胆囊切除术对机体免疫应激和肝功能影响的对比研究

A Comparative Study of Effects of Laparoscopic Cholecystectomy and Open Cholecystectomy on Immunity Stress and Liver Function

目的对比研究腹腔镜胆囊切除术(LC)与开腹胆囊切除术(OC)对机体免疫、应激和肝功能的影响。方法通过对我院2009年2月-2015年3月肝胆外科就诊收治的150例胆囊结石患者资料做回顾性分析,根据手术方式的不同分为LC组和OC组两组,检测并对比两种手术方式对两组患者免疫功能、肝功能、应激功能的影响。结果两组患者术前1 d IgA、IgM、IgG、ALT、AST、TBIL、CRP、BG、肾上腺素水平比较无明显差异,具有可比性(P>0.05),术后第2天、第5天,LC组IgA、IgM、IgG水平明显均高于OC组,ALT、AST、TBIL、CRP、BG、肾上腺素上升水平均明显低于OC组(P<0.05,P<0.01),且上述指标趋于正常水平较OC组快(P<0.05)。结论 LC和OC均对患者的免疫功能、应激和肝功能有一定的影响,相对而言LC对机体的负性刺激更小,是较为安全的手术治疗方式,可做为临床首选治疗胆囊结石手术方式。

Objective To compare the effects of laparoscopic cholecystectomy （LC） and open cholecystectomy （OC） on immunity stress and liver function. Methods A total of 150 cases of cholecystolithiasis treated in our hospital from February 2009 to March 2015 were analyzed retrospectively. According to operation methods, these patients were divided into two groups： the LC group and OC group. The immune function, liver function and stress function of the two groups of patients were observed. Resuits No significant difference was detected in IgA, IgM, IgG, ALT, AST, TBIL, CRP, BG and adrenaline levels between the two groups before operation （ P〉0. 05 ）. On the second and fifth day after operation, levels of IgA, IgM and IgG were significantly higher in the LC group than in the OC group, The levels of ALT, AST, TBIL, CRP, BG and epinephrine in the LC group were significantly lower than those in the OC group （ P〈0.05 ,P〈0.01 ） while the levels of above indicators in the LC group were high- er than those in the OC group （P〈0. 05 ）. Conclusion Both LC and OC have some influence on the immune function, stress and liver function of patients. LC is a safer way to treat organisms and can be used as the first option for clinical treatment of gallblad- der stones.