腹腔镜下胆囊切除术对机体免疫功能及应激水平的影响

Effect of laparoscopic cholecystectomy on the body's stress and humoral immune function

目的探讨腹腔镜下胆囊切除术对机体体液免疫功能及应激水平的影响。方法于2012年6月至2016年5月,选取我院收治的316例急性结石性胆囊炎患者,随机分为试验组(腹腔镜下胆囊切除术)和对照组(传统开腹胆囊切除术),各158例。观察两组术前及术后3 d的CRP、IL-6及TNF-α水平和CD_3^+与CD_4^+值的变化情况。结果术后3 d,两组的CRP、IL-6和TNF-α水平均升高,且试验组显著低于对照组(P<0.05)。术后3 d,试验组的外周血淋巴细胞CD_3^+及CD_4^+值与术前比较,差异无统计学意义(P>0.05),对照组的外周血淋巴细胞CD_3^+及CD_4^+值显著低于术前与试验组(P<0.05)。结论腹腔镜下胆囊切除术对患者机体体液免疫功能及应激的保护优于传统开腹胆囊切除术。

Objective To observe the effect of laparoscopic cholecystectomy on the body＇s stress and humoral immune function.Methods From June 2012 to May 2016,316 patients with acute calculous cholecystitis in our hospital were selected and randomly divided into experimental group（took laparoscopic cholecystectomy）and control group（took traditional open cholecystectomy）,with 158 cases in each group.The levels of CRP,IL-6 and TNF-α,and the changes of CD3~＋and CD4~＋were observed before operation and 3 d after operation in both groups.Results At 3 d after surgery,the levels of CRP,IL-6 and TNF-αin the two groups increased,and those of the experimental group were significantly lower than the control group（P〈0.05）.There were no significant differences in the CD3~＋and CD4~＋of peripheral blood lymphocytes in the experimental group between the preoperative and 3 d after surgery（P〉0.05）;the levels of CD3~＋and CD4~＋in the peripheral blood in the control group were significantly lower than those in the preoperative and experimental group（P〈0.05）.Conclusion Laparoscopic cholecystectomy surgery is superior to open cholecystectomy surgery in stress protection and immune function.