腹腔镜与开腹胆囊切除术对机体免疫功能影响的临床研究  

Effect of laparoscopic cholecystectomy and open surgery on immune system

作　　者：刘亮[1] 鲁焕章[1] 丁洁[1] 李继坤[1] 李学杰 

机构地区：[1]天津南开医院,300100

出　　处：《中华消化内镜杂志》1999年第5期284-286,共3页Chinese Journal of Digestive Endoscopy

摘　　要：目的　研究腹腔镜胆囊切除术（ＬＣ）和开腹胆囊切除术（ＯＣ）对机体免疫功能的影响。方法　监测７０ 例（ＬＣ及ＯＣ各３５ 例）胆囊结石患者术前、术后第一天、术后第三天的外周血淋巴细胞（ＰＢＬ）亚群、补体Ｃ３ 及白细胞介素－６（ＩＬ－６）和肿瘤坏死因子（ＴＮＦ）的变化并行对比研究。结果　ＯＣ组术后第三天成熟的Ｔ淋巴细胞（ＣＤ３）、辅助性Ｔ细胞（ＣＤ４）、ＣＤ４／抑制性Ｔ淋巴细胞（ＣＤ８）比值较术前明显下降（Ｐ＜ ０．０５ 或Ｐ＜ ０．０１），且两组相比较，ＯＣ组明显低于ＬＣ组（Ｐ＜ ０．０１），ＯＣ组术后第一天或／和第三天Ｃ３、ＩＬ－６、ＴＮＦ较术前明显升高（ Ｐ＜ ０．０１）。且两组比较ＯＣ组明显高于ＬＣ组（Ｐ＜ ０．０１）。结论　ＬＣ对机体免疫及细胞因子水平影响较小，这构成了ＬＣ术后恢复较快的病理生理基础。Objective The consequences of laparoscopic cholecystectomy(LC) and open cholecystectomy(OC) exerted on human immune system were reported. Methods Multiple immunoassays were tested and compared postoperatively in each of 35 patients after LC or OC under general anesthesia. Results Postoperative levels of CD3, CD4 and CD4/CD8 in cases having had OC decreased significantly than those undergoing LC ( P<0.05 and P<0.01 ). Whereas the concentrations of complement C3, interleukin-6(IL-6)and tumor necrosis factor(TNF) of the former increased evidently ( P<0.01 ) than the latter. Conclusion It is suggested that LC impose less influences on immunoassays with sooner recovery to preoperative levels.

关 键 词：腹腔镜 胆囊切除术 免疫功能 

分 类 号：R657.4[医药卫生—外科学]