摘要
目的探究微创手术对胆结石并发急性胆囊炎患者免疫功能及术后并发症的影响。方法方便选取2015年7月—2018年9月该院收治的胆结石并发急性胆囊炎患者100例,根据治疗方案的不同分为研究组(50例)及对照组(50例)。对照组予以传统手术治疗,研究组则行腹腔镜胆囊切除术治疗。比较两组术中情况、免疫球蛋白、T淋巴细胞亚群及术后并发症等指标的差异。结果研究组手术时间、术中出血量及住院时间数值(35.59±6.48)min,(61.28±11.19)mL,(5.38±1.80)d皆明显低于对照组(61.87±7.25)min,(98.50±10.42)mL,(11.29±4.34)d(P<0.05);研究组术后出血、切口感染、皮下气肿、膈下脓肿发生率(8.00%,0.00%,8.00%,0.00%)均低于对照组(24.00%,12.00%,26.00%,10.00%)(P<0.05);研究组术后7 d的血清CD3+水平(60.41±3.48)较对照组升高(52.35±3.51)(P<0.05),而两组血清CD4+、CD8+及其余时刻CD3+水平比较,组间差异无统计学意义(P>0.05);研究组术后1 d及术后7 d的血清IgG水平(10.80±1.23)、(12.80±1.73)g/L较对照组明显升高(9.74±1.31)、(11.52±1.55)g/L(P<0.05),而两组血清IgM、IgA及术前IgG水平比较,组间差异无统计学意义(P>0.05)。结论腹腔镜胆囊切除术对胆结石并发急性胆囊炎患者免疫功能影响较小,能有效降低术后并发症发生率,疗效确切。
Objective To investigate the effect of minimally invasive surgery on immune function and postoperative complications in patients with gallstone complicated with acute cholecystitis. Methods A total of 100 patients with gallstones complicated with acute cholecystitis admitted to our hospital from July 2015 to September 2018 were convenient enrolled.According to the treatment plan, they were divided into study group(50 cases) and control group(50 cases). The control group was treated with conventional surgery, and the study group underwent laparoscopic cholecystectomy. The differences in intraoperative conditions, immunoglobulins, T lymphocyte subsets, and postoperative complications were compared between the two groups. Results The operation time, intraoperative blood loss and hospitalization time(35.59 ±6.48)min,(61.28 ±11.19)mL,(5.38 ±1.80)d were significantly lower in the study group than in the control group(61.87 ±7.25)min,(98.50±10.42)mL,(11.29±4.34)d(P<0.05). The incidence of postoperative bleeding, wound infection, subcutaneous emphysema, subgingival abscess and biliary fistula in the study group(8.00%, 0.00%, 8.00%, 0.00%) were lower than those in the control group(24.00%, 12.00%, 26.00%, 12.00%)(P<0.05);serum CD3+ level(60.41±3.48)% was higher in the study group than in the control group(52.35±3.51)%(P<0.05), while serum CD4+, CD8+ and others in the study group. There was no significant difference between the groups(P>0.05). The serum IgG levels(10.80±1.23)g/L,(12.80±1.73)g/L were significantly higher in the study group than in the control group(9.74±1.31)g/L,(11.52±1.55)g/L(P<0.05), there was no significant difference between the two groups(P>0.05). Conclusion Laparoscopic cholecystectomy has little effect on the immune function of patients with gallstones complicated with acute cholecystitis, which can effectively reduce the incidence of postoperative complications.
作者
张军
ZHANG Jun(Department of Intervention, the Fourth Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, 110101 China)
出处
《中外医疗》
2019年第7期51-53,共3页
China & Foreign Medical Treatment
关键词
微创手术
免疫功能
术后并发症
胆结石并发急性胆囊炎
Minimally invasive surgery
Immune function
Postoperative complications
Gallstones complicated with acute cholecystitis
