腹腔镜胆囊切除术对胆囊结石患者应激反应、肝功能、能量代谢及细胞免疫功能的影响

Effects of laparoscopic cholecystectomy on stress response, liver function, energy metabolism and cellular immune function in patients with gallstone

目的探讨腹腔镜胆囊切除术对胆囊结石患者应激反应、肝功能、能量代谢及细胞免疫功能的影响。方法将我院收诊的84例胆囊结石患者以分层随机法分为观察组与对照组,各42例。观察组采用腹腔镜胆囊切除术,对照组采用开腹胆囊切除术。比较两组患者术前及术后2 d的应激指标、肝功能指标、能量代谢指标及细胞免疫功能指标。结果术后2 d,两组患者肾上腺素、BG、CRP水平均升高,但观察组低于对照组(P<0.05)。术后2 d,两组患者TBIL、AST、ALT水平均显著高于术前,但观察组低于对照组(P<0.05)。术后2 d,两组Hb、PA、ALB水平均低于术前,但观察组高于对照组(P<0.05)。术后2 d,两组IgM、IgA、IgG水平均低于术前,但观察组高于对照组(P<0.05)。结论腹腔镜胆囊切除术可有效改善胆囊结石患者的应激反应与机体能量代谢,降低患者肝功能损害程度及对细胞免疫功能的影响。

Objective To investigate the effects of laparoscopic cholecystectomy on stress response, liver function,energy metabolism and cellular immune function in patients with gallstone. Methods Eighty-four patients with gallstone enrolled in our hospital were divided into observation group and control group, with 42 cases in each group. The observation group was given laparoscopic cholecystectomy, while the control group was given open cholecystectomy. The stress indexes, liver function indexes, energy metabolism indexes and cellular immune function indexes of the two groups were compared before and at 2 days after operation. Results At 2 days after operation, the levels of adrenaline, BG and CRP in the two groups increased, but those in the observation group were lower than the control group(P<0.05). At 2 days after operation, the levels of TBIL, AST and ALT in the two groups were significantly higher than those before operation,but those in the observation group were lower than the control group(P<0.05). At 2 days after operation, the levels of Hb,PA and ALB in the two groups were lower than those before operation, but those in the observation group were higher than the control group(P<0.05). At 2 days after operation, the levels of IgM, IgA and IgG in the two groups were lower than those before operation, but those of the observation group were higher than the control group(P <0.05). Conclusion Laparoscopic cholecystectomy can effectively improve the stress response and energy metabolism of patients with gallstone,reduce the degree of liver function damage and the impact on cellular immune function of patients.