腹腔镜手术对胆囊切除患者免疫功能的影响

The effects of laparoscopic operation on immunologic function in the patients of laparoscopic cholecystectomy

目的:研究经腹腔镜行胆囊切除患者手术前后周围静脉血体液免疫、细胞免疫、急性期反应蛋白(CRP)及腹腔内细胞免疫功能的改变。方法:术前抽取周围静脉自凝血2ml,应用全自动分析仪测定IgG、IgA、IgM、CRP;抽取周围静脉防凝新鲜血2ml测定中性粒细胞吞噬功能。术后12h再次抽取周围静脉血检测上述指标。术中留取腹腔血性渗液测定中性粒细胞吞噬功能,并与术中测定的周围血相应值比较。结果:周围血体液及细胞免疫功能术后12h与术前相比明显降低(P<0.05),CRP较术前明显升高(P<0.05),腹腔内的中性粒细胞吞噬功能明显降低(P<0.01)。结论:腹腔镜手术可使胆囊切除患者免疫功能减弱。

Objective:To study the changes of humoral immunity,cell immunity,C-reactive pro-tein (CRP)between pre-and post-laparoscopic operation in the patients of cholecystectomy,and the changes of cell immunity in abdominal cavity.Methods:To draw2ml coagulative blood of peripheral veins30min before laparoscopic operation to assay IgG,IgA,IgM,CRP with automatic analyzer,and2ml fresh blood to assay phagocytic function of neutrophil.And assayed again12hours after operation for comparison.To assay the intraoperational phagocytic function of neutrophil in abdominal exudative juice and compare with the indexes of peripheral vein blood.Results:The humoral immunity,cell im-munity of peripheral blood decreased obviously(P<0.05),and the CRP in peripheral blood increased obviously (P<0.05)12hours after operation.The introabdominal phagocytic function of neutrophil de-creased obviously(P<0.01).Conclu sions:The laparoscopic operation causes the immunologic decreasing in blood system and in the abdominal cavity.