免气腹腹腔镜胆囊切除术对结石性胆囊炎患者IL-1及TNF-α水平的影响

Effect of Gasless Laparoscopic Cholecystectomy on IL-1 and TNF-α Levels in Patients with Calculous Cholecystitis

目的:探讨免气腹腹腔镜胆囊切除术对结石性胆囊炎患者IL-1及TNF-α水平的影响。方法:选取2019年3月-2021年3月本院收治的82例结石性胆囊炎患者,根据随机数字表法将其分为对照组和研究组,每组41例。对照组应用常规腹腔镜胆囊切除术治疗,研究组应用免气腹腹腔镜胆囊切除术治疗。比较两组并发症发生情况,手术前后的炎性指标[白细胞介素-1(IL-1)、白细胞介素-8(IL-8)、C反应蛋白(CRP)以及肿瘤坏死因子-α(TNF-α)]、肝功能[血清总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)]及免疫功能(CD3^(+)、CD4^(+)、CD8^(+))。结果:术前,两组IL-1、IL-8、CRP、TNF-α、TBIL、ALT、AST、CD3^(+)、CD4^(+)、CD8^(+)比较,差异均无统计学意义(P>0.05);术后,研究组IL-1、IL-8、CRP、TNF-α、TBIL、ALT、AST水平均低于对照组,CD3^(+)、CD4^(+)、CD8^(+)均高于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:结石性胆囊炎患者进行免气腹腹腔镜胆囊切除术治疗效果更好,并发症少,不仅可以降低IL-1及TNF-α等水平,还可改善肝功能,提高机体免疫力,有较高的安全性,值得应用。

Objective:To investigate the effect of gasless laparoscopic cholecystectomy on IL-1 and TNF-α levels in patients with calculous cholecystitis.Method:A total of 82 patients with calculous cholecystitis admitted to our hospital from March 2019 to March 2021 were selected,they were divided into control group and study group according to random number table method,41 cases in each group.The control group was treated with conventional laparoscopic cholecystectomy,and the study group was treated with gasless laparoscopic cholecystectomy.The incidence of complications was compared between two groups,the inflammatory indicators[interleukin-1 (IL-1),interleukin-8 (IL-8),C-reactive protein (CRP) and tumor necrosis factor-α(TNF-α)],liver function[serum total bilirubin (TBIL),alanine transaminase (ALT),aspartate aminotransferase (AST)]and immune function (CD3^(+),CD4^(+),CD8^(+)) before and after surgery were compared between two groups.Result:Before surgery,there were no significant differences in IL-1,IL-8,CRP,TNF-α,TBIL,ALT,AST,CD3^(+),CD4^(+) and CD8^(+) between two groups (P>0.05);after surgery,the levels of IL-1,IL-8,CRP,TNF-α,TBIL,ALT and AST in the study group were lower than those in the control group,while CD3^(+),CD4^(+) and CD8^(+) in the study group were higher than those in the control group,the differences were statistically significant (P<0.05).The incidence of complications in the study group was lower than that in the control group,the difference was statistically significant (P<0.05).Conclusion:Gasless laparoscopic cholecystectomy for patients with calculous cholecystitis has better therapeutic effect and fewer complications.It can not only reduce the levels of IL-1 and TNF-α,but also improve the liver function and immunity of the body.Which has high safety and is worthy of application.