首页|腹腔镜下三孔法胆囊切除术对急性结石性胆囊炎患者术后机体应激反应及免疫功能的影响分析

腹腔镜下三孔法胆囊切除术对急性结石性胆囊炎患者术后机体应激反应及免疫功能的影响分析

Effect of Laparoscopic Three-hole Cholecystectomy on Stress Response and Immune Function in Patients with Acute Calculous Cholecystitis

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目的 分析急性结石性胆囊炎患者应用腹腔镜下三孔法胆囊切除术对术后机体应激反应及免疫功能的影响.方法 选取2019年12月至2022年12月本院收治的95例急性结石性胆囊炎患者作为研究对象,采用抽签法将其分为开腹组和腹腔镜组.开腹组47例行开腹手术治疗,腹腔镜组48例行腹腔镜下三孔法胆囊切除术治疗.对比两组手术相关指标、机体应激反应状态、免疫功能、术后并发症.结果 腹腔镜组术中出血量、住院时间均低于开腹组,手术时间高于开腹组,差异有统计学意义(P<0.05);术后7 d,腹腔镜组P物质(SP)、前列腺素E2(PGE2)、5羟色胺(5-HT)、促肾上腺素激素(ACTH)水平均低于开腹组,差异有统计学意义(P<0.05);术后7 d,腹腔镜组CD3+、CD4+、CD8+、自然杀伤细胞(NK)水平均高于开腹组,差异有统计学意义(P<0.05);腹腔镜组术后并发症发生率低于开腹组(2.08%<14.89%),差异有统计学意义(P<0.05).结论 腹腔镜下三孔法胆囊切除术能够有效减少急性结石性胆囊炎患者术中出血量,缩短住院时间,减轻术后应激反应,调节免疫抑制状态,降低术后并发症发生率.
Objective To analyze the effects of laparoscopic three-hole cholecystectomy on stress response and immune function in patients with acute calculous cholecystitis.Methods A total of 95 patients with acute calculous cholecystitis admitted to our hospital from December 2019 to December 2022 were selected as research objects and divided into groups by lottery method.Forty-seven patients in the laparotomy group underwent la-parotomy,and 48 patients in the laparoscope group underwent cholecystectomy with three holes.Operation-re-lated indexes,stress response state,immune function and postoperative complications were compared between the two groups.Results The intraoperative blood loss and hospital stay of the experimental group were lower than those of the control group,and the operative time was higher than that of the control group(P<0.05).On day 7 after surgery,the levels of substance P(SP),prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT)and adrenalin stimulating hormone(ACTH)in experimental group were lower than those in control group(P<0.05).On day 7 after operation,the levels of CD3+,CD4+,CD8+and NK in experimental group were higher than those in control group(P<0.05).The incidence of postoperative complications in experimental group was lower than that in control group(2.08%<14.89%)(P<0.05).Conclusions Laparoscopic three-hole cholecystectomy can effectively shorten intraoperative blood loss and hospital stay in patients with acute cal-culous cholecystitis,reduce postoperative stress response,regulate immunosuppression,and reduce the incidence of postoperative complications.

laparoscopic three-hole cholecystectomyacute calculous cholecystitisbody stress responseim-mune function

杨建华、王旭、郭晓华

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河南省临颍县人民医院,河南漯河 462600

腹腔镜下三孔法胆囊切除术 急性结石性胆囊炎 机体应激反应 免疫功能

河南省自然科学基金项目

20220506

2024

内蒙古医学杂志
内蒙古自治区医学会

内蒙古医学杂志

影响因子:0.537
ISSN:1004-0951
年,卷(期):2024.56(3)