摘要
目的探讨腹腔镜胆囊切除术治疗胆囊结石的疗效及其对患者免疫因子的影响。方法选取2013—2016年安阳市人民医院收治的胆囊结石患者119例,采用随机数字表法分成治疗组57例和对照组62例,治疗组予腹腔镜下胆囊切除治疗,对照组予传统开腹手术治疗。随访18个月,比较两组患者术中情况、炎性因子、CD4+和CD8+及术后并发症。结果治疗组平均手术时间为(33.3±5.9)min短于对照组的(70.3±11.2)min(P<0.05);治疗组术中出血量为(35.2±5.8)ml少于对照组的(50.7±6.7)ml(P<0.05);治疗组肛门排气时间为(27.3±4.3)h短于对照组的(49.6±9.1)h(P<0.05);治疗组平均住院时间为(9.1±3.6)d短于对照组的(14.0±5.1)d(P<0.05)。术后,治疗组的超敏C反应蛋白(hs-CRP)为(13.50±3.74)mg/L低于对照组的(19.70±4.37)mg/L;治疗组的白介素6(IL-6)为(33.78±5.73)ng/L低于对照组的(51.47±7.21)ng/L;治疗组的CD4+为(38.14±3.13)高于对照组的(31.79±4.37)mg/L;治疗组的CD8+为(27.37±3.43)ng/L高于对照组的(22.34±2.71)ng/L。术后随访18个月,两组切口渗血、切口感染、胆漏和肠梗阻发生率比较,差异均无统计学意义(P>0.05)。结论腹腔镜胆囊切除术治疗胆囊结石具有手术时间短、术中出血量少、胃肠功能恢复快和住院时间短的优势,且能减少术后炎性反应和免疫功能影响。
Objective To investigate the effect of laparoscopic cholecystectomy on cholecystolithiasis and its influence on inflammatory factors.Methods 119 patients with holecystolithiasis admitted to Anyang People’s Hospital from2013 to 2016 were selected.Divided into treatment group(n=57)and control group(n=62)by random number table method.The treatment group was treated with laparoscopic cholecystectomy,while the control group was treated with laparotomy.The operation conditions,inflammatory factors,CD4+and CD8+and postoperative complications were compared between the two groups.Results The mean operation time in the treatment group was shorter than that in the control group〔(33.3±5.9)min vs(70.3±11.2)min,P<0.05〕.The amount of bleeding in the treatment group was lower than that in the control group〔(35.2±5.8)ml vs(50.7±6.7)ml,P<0.05〕.The time of anal aerofluxus in treatment group than was shorter than that in the control group〔(27.3±4.3)h vs(49.6±9.1)h,P<0.05〕.The hospital stays in treatment group was also shorter than that in the control group〔(9.1±3.6)d vs(14.0±5.1)d,P<0.05〕.After surgery treatment,the hs-CRP in treatment group was(13.50±3.74)mg/L,which was significantly lower than(19.70±4.37)mg/L in control group(P<0.05).The IL-6 in treatment group was(33.78±5.73)ng/L,which was significantly lower than(51.47±7.21)ng/L in control group(P<0.05).The CD4+in treatment group was(38.14±3.13),and in control group it was(31.79±4.37),which was significantly lower than treatment group(P<0.05).The CD8+in treatment group was(38.14±3.13),and in control group it was(31.79±4.37),which was significantly lower than treatment group(P<0.05).However,adverse events of postoperative bleeding,postoperative infection,postoperative bile leakage and intestinal obstruction was no significant differences between two group after 18 months follow up(P>0.05).Conclusion Compared to the laparotomy,the laparoscopic cholecystectomy has the advantages of shorter operation time,lower blood loss quicker recovery of gastrointestinal function and lower hospital stays.And it had lighter inflammatory response and immune function suppression.
作者
王现兵
王嘉毅
孙广增
贾彭松
WANG Xianbing;WANG Jiayi;SUN Guangzeng;JIA Pengsong(Anyang People's Hospital,Anyang 455000,China)
出处
《中国全科医学》
CAS
北大核心
2019年第A01期28-31,共4页
Chinese General Practice
