腹腔镜手术对胆囊结石合并急性胆囊炎患者应激及免疫能力的影响

Effect of Laparoscopic Surgery on Stress and Immunity of Patients with Gallbladder Stone Complicated with Acute Cholecystitis

目的分析腹腔镜手术对胆囊结石合并急性胆囊炎患者应激及免疫能力的影响。方法 2016年3月—2017年3月期间收集该院胆囊结石合并急性胆囊炎患者共118例,根据电脑机选随机化分段将所有患者分为2组,其中研究组患者59例,采用腹腔镜手术方式;常规组患者59例,采用传统开腹手术方式。经不同治疗方式后对两组患者的机体应激和免疫能力进行比较和分析。结果研究组IL-6(74.3±6.05)pg/m L,CRP(0.14±0.07)mg/DL,皮质醇(144.3±8.12)ng/m L,ACTH(107.5±7.2)%,血糖(92.8±7.6)mg/d L,结果优于常规组,差异有统计学意义(t=10.457 3、16.302 6、24.274 2、7.064 0、9.912 8,P<0.05)。免疫功能比较中研究组患者CD3(71.8±6.5),CD4(44.1±3.7),CD8(25.4±3.9),CD4/CD8(1.66±0.11)优于常规组,两组间比较差异有统计学意义(t=6.315 0、8.985 9、3.157 3、7.667 8,P<0.05)。结论采用腹腔镜手术对胆囊结石合并急性胆囊炎患者进行治疗能够起到良好的治疗效果,同时对患者的机体应激以及免疫功能有着显著影响,在临床中值得推广使用。

Objective To analyze the effect of laparoscopic surgery on the stress and immunity of patients with gallbladder stones and acute cholecystitis. Methods From March 2016 to March 2017, a total of 118 patients with gallbladder stones and acute cholecystitis in the hospital were collected. All patients were divided into 2 groups according to the randomized segmentation of computerized machines. Among them, 59 patients in the study group used abdominal cavity mirror surgery; routine group of 59 patients, using traditional open surgery. After different treatment methods, the stress and immunity of the two groups were compared and analyzed. Results Study group IL-6（74.3±6.05）pg/mL, CRP（0.14±0.07）mg/DL, Cortisol（144.3±8.12）ng/mL, ACTH（107.5±7.2）%, Blood glucose（92.8±7.6）mg/dl, were better than that of the conventional group, and the difference was statistically significant（t=10.457 3, 16.302 6, 24.274 2, 7.064 0,9.912 8, P〈0.05）. Compared with the conventional group, CD3（71.8 ±6.5）, CD4（44.1±3.7）, CD8（25.4±3.9）, and CD4/CD8（1.66±0.11） were superior to those of the conventional group in the immunological function comparison group.There was a statistically significant difference between the two groups（t=6.315 0, 8.985 9, 3.157 3, 7.667 8, P〈0.05）.Conclusion Laparoscopic surgery for gallbladder stones combined with acute cholecystitis can provide good therapeutic effect. At the same time, it has a significant impact on the patient＇s body stress and immune function. It is worthy of promotion in clinical practice.