双镜联合微创保胆取石术对胆囊结石患者胃肠功能和免疫球蛋白的影响

The influence of approach of treating cholecystalithiasis and preservation cholecyst by laparoscopy combined with choledochoscopy in the method of minimal invasive on gastrointestinal function and immunoglobulin of patients

目的探讨胆囊结石患者采用双镜联合微创保胆取石术治疗对免疫球蛋白与胃肠功能的影响。方法选取2015年7月—2018年6月本院收治的55例胆囊结石患者为研究对象,按随机数表法分为对照组(27例)和观察组(28例)两组。对照组采用腹腔镜胆囊切除术治疗,观察组采用双镜联合微创保胆取石术治疗。对比两组手术指标、胃肠功能指标、免疫球蛋白水平及并发症发生情况。结果观察组手术时间长于对照组,肛门排气时间、肠鸣音恢复时间、饮食恢复时间均短于对照组,术中出血量少于对照组(P<0.05);与术前对比,两组患者术后24 h时胃泌素、胃动素水平均有所降低,但观察组高于对照组(P<0.05);与对照组相比,观察组术后5 d的免疫球蛋白A(Ig A)、免疫球蛋白M(Ig M)、免疫球蛋白G(Ig G)水平更高(P<0.05);观察组并发症发生率为3.57%(1/28),低于对照组的22.22%(6/27)(χ^2=4.305,P=0.038);术后1年,观察组疾病复发率为3.57%(1/28),低于对照组的25.93%(7/27)(χ^2=5.526,P=0.038)。结论胆囊结石患者采用双镜联合微创保胆取石术治疗对胃肠功能、机体免疫功能产生的影响较小,且并发症发生率低。

Objective To explore the influence of approach of treating cholecystalithiasis and preservation cholecyst by laparoscopy combined with choledochoscopy in the method of minimal invasive on gastrointestinal function and immunoglobulin of patients.Methods 55 patients with gallstone who were admitted to our hospital from July 2015 to June 2018 were selected,they were randomly divided into two groups,the control group(n=27)was treated with laparoscopic cholecystectomy,and the observation group(n=28)was treated with approach of treating cholecystalithiasis and preservation cholecyst by laparoscopy combined with choledochoscopy in the method of microscopic trauma.The operation index,gastrointestinal function index,immunoglobulin level and complications of the two groups were compared.Results The operation time of the observation group was longer than that of the control group,the time of anus exhaust,bowel sound recovery and diet recovery were shorter than those of the control group,and the amount of bleeding during operation was less than that of the control group(P<0.05).Compared with that before operation,the levels of gastrin and motilin decreased on average at 24 hours after operation in both two groups,but this in the the observation group was higher than the control group(P<0.05).Compared with the control group,the levels of immunoglobulin A(Ig A),immunoglobulin M(Ig M)and immunoglobulin G(Ig G)in the observation group were higher at 5 thday after operation(P<0.05).The incidence of complications in the observation group was 3.57%(1/28),which was lower than 22.22%(6/27)in the control group(χ^2=4.305,P=0.038).Conclusions Approach of treating cholecystalithiasis and preservation cholecyst by laparoscope combined with choledochoscope in the method of minimal invasive has little effect on gastrointestinal function and immune function,and the incidence of complications is low.