腹腔镜微创手术治疗老年急性胆囊炎患者的疗效及对机体免疫功能的影响  

The clinical effects of laparoscopic surgery on acute cholecystitis and immunologic function in elderly patients

作　　者：吴友祥[1] 杨俊杰[1] 晏彬[1] 陆炳站 肖进[1] 

机构地区：[1]百色市人民医院肝胆胃肠外科,广西533000

出　　处：《中国临床新医学》2017年第4期347-350,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨腹腔镜微创手术治疗老年急性胆囊炎患者的疗效及对机体免疫功能的影响。方法选择该院2014-01~2015-12收治的72例老年急性胆囊炎患者按随机数字表法分为腹腔镜组(37例)和开腹组(35例),比较两组治疗效果及对机体免疫功能的影响。结果腹腔镜组手术切口长度、术后肛门排气时间、下床活动时间、住院时间均明显短于开腹组(P<0.01),术中出血量明显少于开腹组(P<0.01)。腹腔镜组术后使用止痛药比例明显低于开腹组(P<0.05)。腹腔组术后1 d、7 d外周血CD4^+、CD8^+、CD4^+/CD8^+含量均明显高于开腹组,而CRP水平则明显低于开腹组(P<0.05)。结论腹腔镜微创手术治疗老年急性胆囊炎患者安全有效,具有创伤小、疼痛轻、恢复快等优点,且对患者免疫功能影响小,值得临床推广应用。Objective To investigate the clinical effects of laparoscopic surgery on acute cholecystitis and immunologic function in elderly patients.Methods Seventy-two elderly patients with acute cholecystitis were randomly divided into the laparoscopic cholecystectomy（LC） group（n = 37） and the open cholecystectomy（OC） group（n = 35）.The clinical effects and immunologic function were compared between the two groups.Results The operative incision length,anal exhaust time,ambulation time and total hospital stay of the LC group were signigicantly shorter than those of the OC group,and the neam intraoperative bleeding of the LC group was signigicantly less than that of the OC group（P〈0.01）.The ratio of using postoperative analgesics in the LC group was signigicantly lower than that in the OC group（P〈0.05）.The levels of CD4^＋,CD8^＋and CD4^＋/CD8^＋of the LC group 1 and 7 days after the operation were signigicantly higher than those of the OC group,and the levels of CRP of the LC group were signigicantly lower than those of the OC group（P〈0.05）.Conclusion Compared with OC,LC has less trauma,slighter pain and quicker recovery of immune function in the treatment of senile acute cholecystitis.

关 键 词：老年急性胆囊炎 腹腔镜手术 开腹手术 免疫功能 

分 类 号：R656[医药卫生—外科学]