不同手术方法对胆结石患者免疫状态影响研究  

Effects of Different Operating Methods on the Immune Status of Patients with Gallstones

作　　者：林木青[1] 江四平[1] 胡正华[1] 杨演清[1] 毛金水[1] 余强[1] 

机构地区：[1]浙江省常山县人民医院外一科,浙江常山324200

出　　处：《中国现代医生》2011年第36期156-157,160,共3页China Modern Doctor

摘　　要：目的比较不同手术方法对胆结石患者免疫状态的影响。方法将80例胆结石患者按随机数字表法分为传统组和腹腔镜组,每组40例。分别于术前1d和术后3d抽取外周静脉血检测IgGI、gAI、gM、CD3+、CD4+、CD8+、C3、C4、CD4+/CD8+。同时观察手术时间、术中出血量、肠功能恢复时间、住院天数、并发症等临床指标。结果两组均顺利完成手术,腹腔镜组无一例中转开腹。腹腔镜组的手术时间、术中出血量、肠功能恢复时间、住院天数、并发症发生率均低于传统组(P<0.01);腹腔镜组术后3d的IgGI、gAI、gM、CD3+、CD4+、CD8+、C3、C4,CD4+/CD8+均高于传统组(P<0.01)。结论与传统开放手术相比,腹腔镜手术治疗胆结石具有手术切口小、术中出血少、术后肠道功能恢复快、住院时间短、对机体免疫功能影响小等特点,体现了腹腔镜胆道手术的微创性。Objective To compare the effects on the immune status of patients with gallstones by different surgical methods. Meth- ods All of 80 patients with gallstones were randomly divided into the traditional group and the laparoscopic group,40 cases in each group. Peripheral blood samples were collected l d preoperative and 3d postoperative respectively to detect IgG,IgA,IgM,CD3＋,CD4＋, CD8＋,C3,C4,CD4＋/CD8＋. The operative time,blood loss,intestinal function recovery time,hospital stay,complications and other clinical indicators were observed. Results Both groups were successfully operated,and there was no case of conversion to open surgery in la- paroseopic group. Laparoscopic operative time,blood loss,intestinal function recovery time,length of stay,complication rate were lower than that of the conventional group （P〈0.01） respectively. IgG,IgA,IgM,CD3~,CD4＋,CD8~,C3,C4,CD4＋/CD8＋ of laparoscopic surgery 3d after operation were higher than that of the traditional group （P〈0.01）. Conclusion Compared with traditional open surgery,la- paroscopic surgery for gallstones have a small incision,less bleeding,faster recovery of bowel function after surgery,shorter hospital stay, little effect on immune function and other features ,and reflects the laparoscopic minimally invasive for hiliary tract surgery.

关 键 词：胆结石 腹腔镜 免疫 

分 类 号：R657.44[医药卫生—外科学]