腹腔镜胆囊切除术对急性胆囊炎患者免疫功能及预后的影响

Effect of laparoscopic cholecystectomy on immune function and prognosis in patients with acute cholecystitis

目的探讨腹腔镜胆囊切除术对急性胆囊炎患者免疫功能及预后的影响。方法按随机数字表法将2016年2月-2018年8月就诊于该院的急性胆囊炎患者90例分为两组,对照组45例患者行常规开腹手术治疗,研究组45例患者行腹腔镜胆囊切除术治疗。比较两组手术情况、免疫功能和术后并发症发生情况。结果研究组切口长度、术中出血量、手术持续时间及术后首次通气时间等围术期指标均优于对照组,差异有统计学意义(P<0.05);术后对照组CD3^+、CD4^+水平高于研究组,差异有统计学意义(P<0.05);术后两组CD8+水平比较,差异无统计学意义(P>0.05);研究组并发症发生率为4.44%,低于对照组的15.56%,差异有统计学意义(P<0.05)。结论腹腔镜胆囊切除术治疗急性胆囊炎具有创伤小、并发症少及术后恢复快等优势,利于缩短患者康复时间,且对患者的免疫功能影响较小。

【Objective】 To investigate the effect of laparoscopic cholecystectomy on immune function and prognosis in patients with acute cholecystitis.【Methods】 According to the random number table method,90 patients with acute cholecystitis who were admitted to the hospital from February 2016 to August 2018 were divided into two groups. Forty-five patients in the control group underwent routine open surgery, and 45 patients in the study group underwent laparoscopic cholecystectomy. The operation, immune function and postoperative complications of the two groups were compared.【Results】 Perioperative indexes such as length of incision, intraoperative blood loss, duration of operation and time of first ventilation were better in the study group than in the control group, and the differences were statistically significant (P<0.05);after operation the level of CD3^+, CD4^+ in the control group was higher than that in the study group, and the difference was statistically significant (P <0.05);there was no significant difference in the CD8+ level between the two groups (P >0.05). The complication rate was 4.44% in the study group, which was lower than 15.56% in the control group,and the difference was statistically significant (P <0.05).【Conclusion】 Laparoscopic cholecystectomy for acute cholecystitis has the advantages of less trauma,less complications and quick recovery after surgery. It is beneficial to shorten the recovery time of patients and has little effect on the immune function of patients.