腹腔镜胆囊切除术治疗胆囊结石合并肝硬化对CD4^+/CD8^+及肝功能的影响  

Effect of Laparoscopic Cholecystectomy for Gallbladder Stones Combined with Liver Cirrhosis on CD4^+/CD8^+ and Liver Function

作　　者：王成 WANG Cheng(Yandu District Second People's Hospital of Yancheng,Yancheng,Jiangsu 224500,China)

机构地区：[1]盐城市盐都区第二人民医院,江苏盐城224500

出　　处：《大医生》2019年第24期44-46,共3页Doctor

摘　　要：目的探讨腹腔镜胆囊切除术治疗胆囊结石合并肝硬化及对细胞免疫功能和肝功能的影响。方法选取2018年1月至2019年10月盐城市盐都区第二人民医院合并肝硬化的胆囊结石患者40例,根据手术方法分为对照组与实验组,各20例,分别采取开腹胆囊切除术及腹腔镜胆囊切除术。比较2组手术情况、肝功能指标、T淋巴细胞比例及并发症发生率。结果与对照组比较,实验组手术时间和住院时间缩短,术中出血量降低;与术前比较,术后3 d 2组总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)均升高,但实验组低于对照组(P<0.05),术后3 d 2组CD4^+T淋巴细胞以及CD4^+/CD8^+比值均较术前显著降低,实验组高于对照组(P<0.05),2组手术前后CD8^+T淋巴细胞比例差异无统计学意义(P>0.05)。实验组并发症发生率低于对照组(10.00%vs.30.00%,P<0.05)。结论对合并肝硬化的胆囊结石患者采取腹腔镜胆囊切除术效果显著,手术创伤小,减轻对患者肝功能及免疫功能的损伤,且安全性高。Objective To investigate the effect of laparoscopic cholecystectomy for gallbladder stones combined with liver cirrhosis on cellular immune function and liver function.Methods Forty patients with cholecystolithiasis complicated with cirrhosis in the second people's hospital of yandu district,yancheng city from January 2018 to October 2019 were selected.According to the surgical methods,they were divided into the control group and the experimental group,with 20 cases in each group,and respectively underwent open cholecystectomy and laparoscopic cholecystectomy.The operation status,liver function index,T lymphocyte ratio and complication rate of the two groups were compared.Results Compared with the control group,the operation time and hospitalization time of the experimental group shortened,and the intraoperative blood loss reduced;Compared with the preoperative group,TBIL,ALT,and AST increased in the 2 groups 3 days after the operation,and the experimental group was lower than the control group(P<0.05);The CD4^+T lymphocytes and CD4^+/CD8^+ratios of the two groups were significantly lower than those of the preoperation at 3 days after operation(P<0.05);the experimental group was higher than the control group(P>0.05).the incidence of complications in the experimental group was lower than the control group(10.00%vs.30.00%,P<0.05).Conclusion Laparoscopic cholecystectomy is effective for patients with gallbladder stones with liver cirrhosis.The surgical trauma is small,the damage to liver function and immune function is reduced,and the safety is high.

关 键 词：胆囊结石 肝硬化 胆囊切除术 肝功能 免疫功能 

分 类 号：R65[医药卫生—外科学]