摘要
目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)治疗急性结石性胆囊炎疗效及对免疫功能、术后并发症的影响。方法:选取本院2015年3月至2017年2月期间收治的急性结石性胆囊炎患者88例为研究对象,采用随机法随机分为两组。观察组42例行LC术,对照组46例行开腹胆囊切除术(open cholecystectomy,OC)。比较两组手术时间、术中出血量、术后排气时间、住院时间、术后血清C反应蛋白(CRP)和皮质醇水平变化、术后CD3、CD4、CD8和CD4/CD8水平、NK细胞数变化以及术后并发症情况。结果:观察组手术时间(72.36±12.62)min长于对照组(P<0.05),术中出血量(173.63±22.65)m L少于对照组(P<0.05),术后排气时间和住院时间分别为(21.74±7.96)h和(6.35±2.01)d,短于对照组(P<0.05);观察组术后血清CRP和皮质醇水平分别为(4.36±0.25)mg/dl和(257.83±10.74)ng/m L,低于对照组(P<0.05);观察组术后CD3、CD4、CD8、CD4/CD8以及NK细胞数分别为(64.39±5.37)%、(35.74±3.81)%、(23.65±3.17)%、(1.51±0.08)和(16.46±2.85)%,均高于对照组(P<0.05);观察组术后并发症总发病率为4.76%,低于对照组并发症总发病率19.57%(P<0.05)。结论:LC治疗急性结石性胆囊炎疗效显著,可有效减轻患者术后应激反应以及免疫功能抑制,降低并发症发病率。
Objective: To explore the effects of laparoscopic cholecystectomy( LC) on the efficacy of acute calculouscholecystitis and immune function and postoperative complications. Methods: 88 cases of patients with acute calculous cholecystitis treated in our hospital from March 2015 to February 2017 were selected for the study and divided into two groups: the observation group( n = 42,treated with LC surgery) and the control group( n = 46,treated with open cholecystectomy/OC) according to the random number table method.The operative time,intraoperative blood loss,postoperative exhaust time,hospital stays,the changes of postoperative serum C-reactive protein( CRP) levels and cortisol levels,postoperative levels of CD3,CD4,CD8 and CD4/CD8,NK cells changes and postoperative complications were compared between the two groups. Results: The operative time was( 72.36 ± 12. 62) min in the observation group,which was significantly longer than that of the control group( P <0.05). The intraoperative blood loss amount was( 173.63±22.65) ml in the observation group,which was significantly less than that in the control group( P <0.05). The postoperative exhaust time and hospital stays were( 21.74±7.96) h and( 6.35±2.01) d,which were significantly shorter than those of the control group( P < 0. 05). The levels of serum CRP and cortisol were( 4. 36 ± 0. 25) mg/dl and( 257.83±10.74) ng/ml respectively in the observation group,which were significantly lower than those in the control group( P < 0. 05). The percentage of CD3,CD4,CD8,CD4/CD8 and NK cells were( 64. 39 ± 5.37) %,( 35.74±3.81) %,( 23.65 ± 3.17) %,( 1.51 ± 0.08) and( 16.46 ± 2.85) % in the observation group,which were significantly higher than those in the control group( P <0.05). The total incidence rate of postoperative complications was 4.76% in the observation group,which was significantly lower than that in the control group with19.57%( P <0.05). Conclusions: LC can have a significant effect,and can effectively reduce the patient's postoperative stress response and immune function inhibition,and reduce the incidence rate of complications in the treatment of acute calculous cholecystitis.
出处
《河北医学》
CAS
2017年第11期1810-1813,共4页
Hebei Medicine
基金
江苏省卫生科技攻关项目
(编号:10563)
