腹腔镜及开腹胆总管探查术对患者血清hs-CRP、IL-6水平的影响

Effects of laparoscopic and open common bile duct exploration on serum hs-CRP and IL-6

目的探讨腹腔镜胆总管探查术(LCBDE)及开腹胆总管探查术(OCBDE)对患者血清超敏C反应蛋白(hs-CRP)和白细胞介素-6(IL-6)水平的影响。方法回顾性分析东莞市人民医院普外科于2014年1月至2016年8月期间收治的48例胆囊结石合并胆总管结石患者的临床诊治资料,根据手术方法将患者分别OCBDE组(n=20)与LCBDE组(n=28),比较两组患者术后不同时点即术前(T0)、术后即刻(T1)、术后24 h(T2)及术后72 h(T3)的血清hs-CRP、IL-6水平。结果 LCBDE组与OCBDE组患者的血清hs-CRP、IL-6水平在T0时点分别为(20.9±3.4)mg/L和(42.3±9.8)ng/L、(19.6±4.8)mg/L和(44.6±7.1)ng/L,两组比较差异均无统计学意义(P>0.05);LCBDE组患者术后T1、T2、T3时点血清hs-CRP、IL-6水平分别为(59.6±10.9)mg/L和(75.6±10.4)ng/L、(78.8±12.7)mg/L和(80.4±21.8)ng/L、(27.7±7.1)mg/L和(44.8±12.7)ng/L,均明显低于OCBDE组的(78.4±14.3)mg/L和(89.4±12.9)ng/L、(88.7±14.6)mg/L和(105.6±24.7)ng/L、(39.5±9.2)mg/L和(60.8±15.2)ng/L,差异均有统计学意义(P<0.05);LCBDE组术中出血量、住院时间分别为(40.3±18.9)m L、(10.2±1.4)d,均明显少于OCBDE组的(72.4±25.2)m L、(13.6±2.0)d,差异均有统计学意义(P<0.05)。结论腹腔镜胆总管探查术与开腹胆总管探查术比较具有创伤小、应激反应轻的优点,有利于患者恢复。

Objective To investigate the effect of laparoscopic common bile duct exploration（LCBDE） and opencommon bile duct exploration（OCBDE） on the levels of serum high sensitivity C reactive protein（hs-CRP） and interleukin-6（IL-6）. Methods The clinical data of 48 cases of cholecystolithiasis and choledocholithiasis patients who treated in De-partment of General Surgery of our hospital from January 2014 to August 2016 were collected and studied retrospectively.According to the operation methods, they were divided into the OCBDE group（n=20） and the LCBDE group（n=28）, and se-rum hs-CRP, IL-6 levels were compared between two groups at preoperative（T0）, immediate postoperative（T1）, postopera-tive 24 h（T2） and postoperative 72 h（T3）. Results The levels of serum hs-CRP and IL-6 in the LCBDE and the OCBDEgroup at T0（preoperative） were（20.9±3.4） mg/L and（42.3±9.8） ng/L,（19.6±4.8） mg/L and（44.6±7.1） ng/L, respectively,and there was no significant difference between the two groups（P〈0.05）. After the operation, the levels of serum hs-CRP andIL-6 at T1, T2, T3 in the LCBDE group were（59.6±10.9） mg/L and（75.6±10.4） ng/L,（78.8±12.7） mg/L and（80.4±21.8） ng/L,（27.7±7.1） mg/L and（44.8±12.7） ng/L, respectively, which were significantly lower than（78.4±14.3） mg/L and（89.4±12.9）ng/L,（88.7±14.6） mg/L and（105.6±24.7） ng/L,（39.5±9.2） mg/L and（60.8±15.2） ng/L of the OCBDE group（P〈0.05）. Theamount of bleeding and the length of stay in the LCBDE group were respectively（40.3±18.9） m L and（10.2±1.4） d, whichwere significantly less than（72.4±25.2） m L and（13.6±2.0） d in the OCBDE group（P〈0.05）. Conclusion Compared withopen common bile duct exploration, laparoscopic common bile duct exploration has the advantages of less trauma and lessstress response, which is beneficial to the recovery of patients.