不同时机腹腔镜胆囊切除术对老年急性胆囊炎患者免疫功能的影响  

Effects of Laparoscopic Cholecystectomy at Different Timing on Immune Function of Elderly Patients with Acute Cholecystitis

作　　者：李勇 王涛[2] LI Yong;WANG Tao(Department of General Surgery,Wuhan Aisa General Hospital,Wuhan 430056,China;Department of General Surgery,Yichang First People's Hospital,Yichang 443001,China)

机构地区：[1]武汉亚心总医院普外科,湖北武汉430056 [2]宜昌市第一人民医院普外科,湖北宜昌443001

出　　处：《临床医学工程》2019年第10期1317-1318,共2页Clinical Medicine & Engineering

摘　　要：目的探讨不同时机腹腔镜胆囊切除术对老年急性胆囊炎患者免疫功能的影响。方法选取2017年2月至2019年1月我院收治的84例老年急性胆囊炎患者作为研究对象,根据不同手术时机分为两组。观察组41例在起病48 h内进行腹腔镜胆囊切除术,对照组43例在起病48 h后进行腹腔镜胆囊切除术。比较两组的手术指标,并发症以及CD3+、CD4+水平。结果观察组患者的术中出血量、术后肛门排气时间、住院时间均显著少于对照组(P<0.05)。术前,两组患者的CD3+、CD4+水平比较,差异无统计学意义(P>0.05);术后3 d,两组的CD3+、CD4+水平均出现一定程度的下降,但观察组患者的CD3+、CD4+水平显著高于对照组(P<0.05)。观察组的总并发症发生率为29.3%,显著低于对照组的62.8%(P<0.05)。结论老年急性胆囊炎患者在起病48 h内进行腹腔镜胆囊切除术,有利于术后免疫功能的恢复,且并发症较少,安全性高。Objective To explore the effects of laparoscopic cholecystectomy at different timing on immune function of elderly patients with acute cholecystitis.Methods Eighty-four cases of elderly patients with acute cholecystitis admitted to our hospital from February 2017 to January 2019 were selected as research objects.According to the different operation timing,patients were divided into two groups.41 cases of the observation group received laparoscopic cholecystectomy within 48 hours of onset,and 43 cases of the control group received laparoscopic cholecystectomy at 48 hours after onset.The operative indicators,complications and levels of CD3+and CD4+were compared between the two groups.Results The intraoperative blood loss,postoperative anal exhaust time and hospitalization time of the observation group were significantly lower than those of control group(P<0.05).Before surgery,no significant difference was found in the levels of CD3+and CD4+between the two groups(P>0.05);Three days after surgery,the levels of CD3+and CD4+in both groups decreased to a certain extent,but the levels of CD3+and CD4+of the observation group were significantly higher than those of the ontrol group(P<0.05).The total incidence of complications of the observation group was 29.3%,significantly lower than 62.8%of the control group(P<0.05).Conclusions The application of laparoscopic cholecystectomy within 48 hours of onset in elderly patients with acute cholecystitis is conducive to the recovery of immune function after surgery,with few complications and high safety.

关 键 词：急性胆囊炎 胆囊切除术 老年患者 免疫功能 

分 类 号：R657.41[医药卫生—外科学]