腹腔镜逆行胆囊次全切除术对慢性胆囊炎伴胆囊结石患者体液免疫功能的影响

Effect of Laparoscopic Retrograde Subtotal Cholecystectomy on Humoral Immune Function in Patients with Chronic Cholecystitis and Gallstones

目的探讨腹腔镜逆行胆囊次全切除术对慢性胆囊炎伴胆囊结石患者体液免疫功能的影响。方法选择2019年1月-2021年3月东海县人民医院普外科收治的慢性胆囊炎伴胆囊结石患者58例,根据入院时间单双数分为试验组和对照组,每组29例。对照组实施腹腔镜逆行胆囊全切除术,试验组实施腹腔镜逆行胆囊次全切除术,比较两组手术指标(手术时间、术后通气时间、术后引流量、首次排气时间、住院时间)、体液免疫功能[免疫球蛋白-M(IgM)、免疫球蛋白-A(IgA)]、疼痛程度、炎性因子水平[白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)]及术后并发症发生情况。结果试验组手术时间、术后通气时间、首次排气时间、住院时间短于对照组,术后引流量少于对照组,差异有统计学意义(P<0.05);试验组IgM、IgA水平高于对照组,IL-6、hs-CRP水平低于对照组,差异有统计学意义(P<0.05);试验组T_(0)~T_(3)时点MPQ评分与对照组比较,差异无统计学意义(P>0.05);试验组并发症发生率为6.90%,低于对照组的31.03%,差异有统计学意义(P<0.05)。结论慢性胆囊炎伴胆囊结石患者实施腹腔镜逆行胆囊次全切除术可降低对体液免疫功能的影响,减轻机体炎性反应,促进恢复,且术后并发症发生率低。

Objective To investigate the effect of laparoscopic retrograde subtotal cholecystectomy on humoral immune function in patients with chronic cholecystitis and gallstones.Methods A total of 58 patients with chronic cholecystitis and gallstones admitted to our hospital from January 2019 to March 2021 were selected and divided into experimental group and control group according to the odd and even number of admission time,with 29 cases in each group.The control group was treated with laparoscopic retrograde cholecystectomy,and the experimental group was treated with laparoscopic retrograde subtotal cholecystectomy.The operation indexes(operation time,postoperative ventilation time,postoperative drainage volume,first exhaust time,hospitalization time),humoral immune function[immunoglobulin-M(IgM),immunoglobulin-A(IgA)],pain degree,inflammatory factor levels[interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)]and postoperative complications were compared between the two groups.Results The operation time,postoperative ventilation time,first exhaust time and hospitalization time in the experimental group were shorter than those in the control group,and the postoperative drainage volume in the experimental group was lower than that in the control group,and the differences were statistically significant(P<0.05).The levels of IgM and IgA in the experimental group were higher than those in the control group,while the levels of IL-6 and hs-CRP were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in MPQ score at T_(0)-T_(3) between the experimental group and the control group(P>0.05).The incidence of complications in the experimental group was 6.90%,which was lower than 31.03%in the control group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic retrograde subtotal cholecystectomy can reduce the effect on humoral immune function in patients with chronic cholecystitis and gallstones,which can reduce the body's inflammatory response,promote recovery,and with low incidence of postoperative complications.