微创手术对结石性胆囊炎患者机体应激及免疫功能的影响

Effects of Minimally Invasive Surgery on Stress and Immune Function in Patients with Calculus Cholecystitis

目的观察腹腔镜胆囊切除术(LC)对结石性胆囊炎(CC)患者机体应激及免疫功能的影响。方法选择该院2017年7月—2019年6月收治的68例CC患者,观察组实施LC,对照组实施OC(传统开腹手术),各34例。对比手术前后患者机体应激和免疫功能变化。结果术前观察组机体应激和免疫功能指标与对照组比较,差异无统计学意义(P>0.05);术后观察组WBC(9.44±2.03)109/L、NEUT%(75.68±12.14)%、IL-6(35.62±5.48)ng/L、CRP(48.57±5.88)mg/L与术前对比差异有统计学意义(t=5.330、4.810、10.680、13.320,P<0.05),但CD3^+、CD4^+、CD8^+、CD4^+/CD8^+、NK与术前对比差异无统计学意义(P>0.05)。对照组术后WBC(13.77±3.12)109/L、NEUT(80.15±13.27)%、IL-6(48.87±6.29)ng/L、CRP(63.40±8.10)mg/L、CD3^+(56.07±5.12)%、CD4^+(30.57±1.45)%、CD8^+(20.88±2.86)%、CD4^+/CD8^+(1.34±0.32)、NK细胞百分比(14.30±1.72)%与术前对比差异有统计学意义(t=6.340、5.870、13.440、16.810、4.33、4.120、3.860、5.100、4.880,P<0.05),与观察组比较差异有统计学意义(P<0.05)。结论相比于开腹手术,腹腔镜胆囊切除术对结石性胆囊炎患者机体应激及免疫功能影响更小,安全性更高。

Objective To observe the effect of laparoscopic cholecystectomy(LC)on the stress and immune function of patients with calculus cholecystitis(CC).Methods 68 patients with CC treated in the hospital from July 2017 to June 2019 were selected.The observation group received LC and the control group received OC(Open Surgery),34 cases each.The body stress and immune function of patients before and after surgery were compared.Results Compared with the control group,the body stress and immune function indexes of the observation group before operation were P>0.05;WBC(9.44±2.03)109/L,NEUT%(75.68±12.14)%,IL-6(35.62±5.48)ng/L,CRP(48.57±5.88)mg/L in the observation group after operation,the difference was statistically significant(t=5.330,4.810,10.680,13.320,P<0.05),but CD3^+,CD4^+,CD8^+,CD4^+/CD8^+NK and preoperative,the difference was not statistically significant(P>0.05).In the control group,WBC(13.77±3.12)109/L,NEUT(80.15±13.27)%,IL-6(48.87±6.29)ng/L,CRP(63.40±8.10)mg/L,CD3^+(56.07±5.12)%,CD4^+(30.57±1.45)%,CD8^+(20.88±2.86)%,CD4^+/CD8^+(1.34±0.32),and percentage of NK cells(14.30±1.72)%were significantly different from those before surgery(t=6.340,5.870,13.440,16.810,4.330,4.120,3.860,5.100,4.880,P<0.05),and the difference was statistically significant between the two groups(P<0.05).Conclusion Compared with laparotomy,laparoscopic cholecystectomy has less effect on the stress and immune function of patients with calculus cholecystitis,and has higher safety.