腹腔镜下胆囊切除术与小切口胆囊切除术治疗胆囊结石的疗效观察及其对免疫功能的影响

Clinical Observation of Laparoscopic Cholecystectomy and Mini-incision Cholecystectomy for Cholelithiasis and its Effect on Immune Function

目的:腹腔镜下胆囊切除术与小切口胆囊切除术治疗胆囊结石的疗效观察及其对免疫功能的影响。方法:2017年10月至2019年4月间于我院普外科择期手术治疗的104例胆囊结石患者,采用简单随机分组法分为试验组(n=52)和对照组(n=52)。对照组行小切口胆囊切除术,试验组行腹腔镜胆囊切除术,比较两组手术相关情况、并发症发生情况、T淋巴细胞亚群水平。结果:试验组治疗总有效率显著高于对照组(94.2%vs.76.9%,P<0.05)。试验组术后并发症发生率低于对照组(11.5%vs.26.9%,P<0.05)。试验组切口总长度、手术时间、术后住院时间、肛门排气时间、下床活动时间均为短于对照组,术中出血量少于对照组(P<0.05)。试验组CD3+、CD4+T、CD4+T/CD8+T水平均高于对照组(P<0.05)。结论:腹腔镜胆囊切除术较小切口胆囊切除术对胆囊结石患者治疗效果更好,免疫抑制作用更小,患者术后恢复更好。

Objective:To explore the clinical observation of laparoscopic cholecystectomy and mini-incision cholecystectomy for cholelithiasis and its effect on immune function.Methods:104 patients with cholecystolithiasis undergoing elective surgery in general surgery of our hospital between October 2017 and April 2019 were divided into the test group(n=52)and the control group(n=52)by simple random grouping method.Patients in the control group were treated with mini-incision cholecystectomy,while patients in the test group were treated with laparoscopic cholecystectomy.The operation conditions,postoperative complications and T lymphocyte subsets between the two groups were compared.Results:The total effective rate of the test group was significantly higher than that of the control group(94.2%vs 76.9%,P<0.05).The incidence of postoperative complications in the test group was lower than that in the control group(11.5%vs.26.9%,P<0.05).The total incision length,operation time,postoperative hospitalization time,anal exhaust time and ambulation time of the taet group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group(P<0.05).The levels of CD3+T,CD4+T,CD4+T/CD8+T in the test group were higher than those in the control group(P<0.05).Conclusion:Laparoscopic cholecystectomy with smaller incision cholecystectomy has better therapeutic effect on patients with gallstone,less immunosuppression and better postoperative recovery.