腹腔镜规范化肝切除与开腹肝部分切除术对肝内胆管结石患者炎症因子、应激激素及免疫功能的影响

Effects of laparoscopic normal hepatectomy and partial hepatectomy on inflammatory factors,stress hormones and immune function in patients with intrahepatic cholelithiasis

目的:探讨腹腔镜规范化肝切除与开腹肝部分切除术对肝内胆管结石患者炎症因子、应激激素及免疫功能的影响。方法:90例肝内胆管结石患者依据随机数字表法分为对照组和观察组,对照组患者接受开腹肝部分切除术治疗;观察组患者接受腹腔镜规范化肝切除治疗,比较两组患者治疗前后炎症因子、应激激素及免疫功能指标水平。结果:治疗前,两组中性粒细胞、CRP、WBC、COR、E、CD3^+、CD4^+、CD8^+及NK细胞水平差异无统计学意义(P>0.05);治疗后,观察组CD3^+、CD4^+及NK细胞水平均显著高于对照组(P<0.05),且两组治疗后均显著低于本组治疗前;观察组中性粒细胞、CRP、WBC、COR、E及CD8^+水平均显著低于对照组,且两组治疗后均显著高于本组治疗前,以上差异均有统计学意义(P<0.05)。结论:与开腹肝部分切除术相比,腹腔镜规范化肝部分切除术可有效降低患者炎性因子及应激激素水平,改善机体免疫功能,具有一定临床价值。

Objective：To investigate the effects of laparoscopic normal hepatectomy and partial open hepatectomy on inflammatory factors,stress hormones and immune function in patients with intrahepatic cholelithiasis.Methods：A total of 90 patients with intrahepatic cholelithiasis were randomly divided into control group and the observation group.The patients in the control group were treated with partial hepatectomy.The patients in the observation group were treated with laparoscopic standard hepatectomy.The levels of inflammatory factors,stress hormones and immune function were compared between the two groups.Results：Before treatment,there was no significant difference in the levels of neutrophile granulocyte,CRP,WBC,COR,E,CD3^＋,CD4^＋,CD8^＋and NK cells between the two groups of neutrophils（P〉0.05）.After treatment,the levels of CD3^＋,CD4^＋ and NK cells in the observation group were significantly higher than those in the control group（P〈0.05）.The levels of neutrophile granulocyte,CRP、WBC、COR、E and CD8^＋ in the observation group were significantly lower than those in the control group（P〈0.05）.Conclusion：Laparoscopic standardized partial hepatectomy can effectively reduce the inflammatory factors and stress hormone levels,improve the immune function of the body,and have a certain clinical value.