腹腔镜下胆囊切除术治疗胆结石患者的疗效及对机体免疫功能的影响  

Efficacy of Laparoscopic Cholecystectomy in Patients with Gallstones and the Effects on the Immune Function

作　　者：薛红娣[1] 刘双海[1] 陈胜[1] 周一夫[1] 汤晓东[1] 周标[1] 胡俊[1] 邓志成[1] 贾竞超[1] 赵振国[1] 

机构地区：[1]江阴市人民医院肝胆外科,江苏江阴214400

出　　处：《医学综述》2016年第24期4914-4916,共3页Medical Recapitulate

摘　　要：目的探讨腹腔镜下胆囊切除术治疗胆结石患者的疗效及对机体免疫功能的影响。方法选取2013年9月至2014年10在江阴市人民医院进行胆结石治疗的患者90例,按照随机数字法分为观察组和对照组,各45例。观察组患者采用腹腔镜胆结石取石手术,对照组采用常规开腹胆结石取石术。观察两组患者治疗后的手术情况、免疫球蛋白(Ig)水平、临床疗效、复发率、并发症发生情况。结果观察组总有效率高于对照组[95.6%(43/45)比82.2%(37/45)](P<0.05)。观察组患者的术中出血量、肛门排气时间、手术时间明显少于对照组[(30±5)m L比(102±24)m L、(511±14)h比(982±23)h、(2.4±0.3)h比(2.7±0.7)h],术后镇痛剂使用率和残石率明显低于对照组[6.7%(3/45)比44.4%(20/45)、6.7%(3/45)比33.3%(15/45)](P<0.05)。术后,观察组Ig A、Ig G以及Ig M显著低于对照组[(1.47±0.12)g/L比(1.73±0.14)g/L、(5.78±1.03)g/L比(7.75±2.12)g/L、(0.98±0.11)g/L比(1.05±0.19)g/L](P<0.01)。观察组复发率、并发症发生率低于对照组[2.2%(2/45)比13.3%(10/45)、11.1%(5/45)比71.1%(32/45)](P<0.05)。结论腹腔镜下胆囊切除术治疗胆结石具有很好的临床效果,可保护患者机体免疫功能。Objective To evaluate the efficacy of laparoscopie cholecystectomy in patients with gall-stones and the effects on immune function. Methods 90 patients with gallstone treated in Jiangyin City People＇s Hospital from Sep. 2013 to Oct. 2014 were included in the study, according to the random number method they were divided into an observation group and a control group ,45 cases each. The observation group received laparoseopic stone gallstone surgery; the control group received conventional open stone surgery. After treatment ,the surgical results, Ig level, clinical efficacy, recurrence rate and complications of the two groups were observed. Results The total effective rate of the observation group was higher than the control group [ 95.6% （43/45） vs 82.2% （37/45） ], and the difference was statistically significant （P 〈 0.05 ）. The blood loss, anal exhaust time, surgery time of the observation group were significantly shorter than the control group [（30±5） mLvs （102±24） mL,（511±14） hvs （982±23） h,（2.4±0.3） hvs （2.7± 0.7 ） h ], postoperative analgesic usage and the residual rate of the observation group were significantly lower than the control group[ 6. 7 % （3/45） vs 44. 4% （20/45） ,6.7 % （3/45） vs 33.3 % （15/45） ], with statistically significant differences （ P 〈 0. 05 ）. After treatment, IgA, IgG and IgM level of the observation group were lower than the control group [ （ 1.47±0. 12 ） g/L vs （ 1.73±0. 14 ） g/L, （ 5.78±1.03 ） g/L vs （7.75 ±2. 12） g/L, （ 0. 98 ± 0. 11 ） g/L vs （ 1.05 ± 0. 19 ） g/L ], with statistically significant differences （ P 〈 0. 01 ）. The recurrence rate and postoperative comphcations of the observation group were lower than the control group [ 2. 2 % （ 2/45 ） vs 13.3 % （ 10/45 ）, 11.1% （ 5/45 ） vs 71.1% （ 32/45 ） ], with statistically significant differences （ P 〈 0. 05 ）. Conclusion Laparoscopic cholecystectomy treatment of gallstones has a good clinical effect,which

关 键 词：胆结石 腹腔镜 胆囊切除术 免疫功能 

分 类 号：R657.42[医药卫生—外科学]