Effects of accelerated rehabilitation surgery on immune function in patients with cholecystolithiasis and choledocholithiasis and its molecular mechanism
Objective To investigate the effects of accelerated rehabilitation surgery(ERAS)on immune function and its molecular mechanism in patients with cholecystolithiasis and choledocholithiasis.Methods A total of 86 patients with cholecystolithiasis and choledocholithiasis admitted to our hospital from January 2022 to December 2023 were selected and randomly divided into control group and accelerated rehabilitation group according to the random number table method,with 43 cases in each group.The con-trol group received routine nursing after laparoscopic cholecystectomy,and the accelerated rehabilitation group received postoperative nursing under the concept of accelerated rehabilitation surgery.The recovery effect and postoperative complications were compared between the two groups.Peripheral blood was isolated from patients before and after surgery,and CD4+,CD8+and CD4+/CD8+ratios were analyzed by flow cytometry.Enzyme-linked immunosorbent assay(ELISA)was used to analyze the serum inflammatory fac-tors C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in the two groups.Measurement data were compared by t test.Results The first postoperative exhaust time,gastro-intestinal function recovery time and hospital stay in control group[(29.03±1.77)h,(35.61±2.57)h,(9.57±1.15)d]were significantly longer than those in accelerated rehabilitation group[(21.15±1.52)h,(26.76±1.61)h,(7.99±0.85)d,t=27.540,22.400,10.490,P＜0.05].The postopera-tive activity time of patients in control group[(24.04±1.33)h]was significantly shorter than that in ac-celerated rehabilitation group[(30.45±2.08)h,t=20.680,P＜0.05].The ratio of CD4+cells to CD8+cells in control group[(46.62±3.31)％,(24.53±2.35)％]was significantly higher than that in accelerated rehabilitation group[(38.19±1.65)％,(21.19±2.74)％,t=9.705,6.084,P＜0.05].The ratio of immune cells CD4+/CD8+in control group(2.01±0.22)was significantly higher than that in accelerated rehabilitation group(1.72±0.22,t=4.093,P＜0.05).CRP,TNF-α,and IL-6 levels in control group[(36.93±2.68),(92.33±6.94),(326.15±24.20)pg/ml]were significantly higher than in accelerated rehabilitation group[(19.48±1.40),(58.45±4.44),(234.81±17.18)pg/ml,t=28.090,20.410,18.610,P＜0.05].Conclusion The concept of accelerated rehabilitation surgery after laparoscopic cholecystectomy can improve the postoperative immune function and reduce the level of inflammation,which is conducive to the postoperative rehabilitation of patients.
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