腹腔镜胆囊切除术对机体炎症免疫反应的影响  

Effect of laparoscopic cholecystectomy on systemic inflammatory immunological reactions

作　　者：王勇[1] 张斌蓉 王青[1] 倪平[1] 赵若愚[1] 侯梅瑾 徐磐[1] 

机构地区：[1]上海市江湾医院普外科,上海200434

出　　处：《中国微创外科杂志》2004年第5期422-423,428,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的对比研究腹腔镜胆囊切除术(laparoscopiccholecystectomy,LC)和开腹胆囊切除术(opencholecystectomy,OC)对机体炎症免疫反应的影响。方法监测胆囊结石或胆囊息肉样病变患者(LC、OC各30例)术前、术后1h、1d、2d的外周血T淋巴细胞亚群、WBC计数、C反应蛋白(C-reactiveprotein,CRP)及白细胞介素-6(IL-6)的变化并进行比较。酶联免疫吸附法(ELISA)检测IL-6,流式细胞仪检测T细胞亚群。结果OC组术后2d,成熟T淋巴细胞(CD3)(q=5822,P<005)、辅助性T淋巴细胞(CD4)(q=10636,P<005)较术前显著下降,2组CD4/CD8在术后1、2d无统计学差别(P>005)。OC组术后2d,WBC计数(t=4904,P=0000)、CRP(t=9409,P=0000)、IL-6(t=6471,P=0000)均明显高于LC组。结论LC对机体炎症免疫反应影响小,有利于术后恢复。Objective To compare laparoscopic cholecystectomy (LC) and open cholecystectomy (OC) on their effects on systemic inflammatory immunological reactions. Methods Peripheral T-lymphocyte subpopulation, white blood cell (WBC) count, C-reactive protein (CRP) and Interleukin-6 (IL-6) before the surgery, 1 hour, 1 day and 2 days after the surgery, respectively, in patients with cholelithiasis or polypoid lesions of the gallbladder receiving either LC (n=30) or OC (n=30), were recorded and compared. The enzyme-linked immunosorbent assay (ELISA) was used for IL-6 determination and the flow cytometry was adopted for T-lymphocyte subpopulation counting. Results The levels of CD3 ( q =5 822, P <0 05) and CD4 ( q =10 636, P <0 05) on the second postoperative day in group OC significantly declined as compared with preoperative levels. No statistical difference was found on levels of CD4/CD8 and CD8 1～2 days after the surgery between the two groups ( P >0 05). Significantly lowered levels of WBC count ( t =4 904, P =0 000), CRP ( t =9 409, P =0 000) and IL-6 ( t =6 471, P =0 000) in group LC as compared with group OC 2 days after the surgery were observed. Conclusions LC imposes less influences on the systemic inflammatory immunological reactions and benefits the patient’s recovery.

关 键 词：腹腔镜胆囊切除术 开腹胆囊切除术 免疫反应 T淋巴细胞 

分 类 号：R657.4[医药卫生—外科学]