摘要
目的研究腹腔镜联合十二指肠镜手术对老年胆结石患者免疫功能的影响。方法选取2014年2月至2015年5月到我院进行治疗的老年胆结石患者80例,将其随机分为对照组和研究组,每组各40例。对照组患者实施常规胆结石开腹手术治疗,研究组实施腹腔镜联合十二指肠镜手术治疗。观察两组患者的临床治疗效果,免疫功能以及并发症的情况。结果两组患者的手术时间相比无显著差异(P>0.05),研究组与对照组患者在术中出血量[(30.1±4.7)m L vs(127.5±23.1)m L]、肛门排气时间[(51.4±13.8)h vs(94.3±16.5)h]、术后镇痛剂使用率(17.5%vs 77.5%)和术后残石率(7.5%vs 32.5%)等方面,存在统计学差异(P<0.05);手术前两组免疫功能指标无显著差异(P>0.05);手术后,研究组患者血清中Ig G、Ig M、Ig A以及CD3、CD4、CD4/CD8的水平均高于对照组患者,CD8低于对照组患者,差异均有统计学意义(P<0.05);研究组并发症发生率为12.5%,对照组为37.5%,两组间比较有显著差异(P<0.05)。结论使用腹腔镜联合十二指肠镜手术治疗老年胆结石的效果显著,对患者的免疫功能具有保护作用,并发症率低,安全可靠,值得在临床上推广使用。
Objective To explore the effect of laparoscopy combined with duodenoscope surgery on immune function of elderly patients with gallstones.Methods 80 elderly patients with gallstones hospitalized during the period from Feb.,2014 to May,2015 were selected and randomly divided into 2 groups：control group and experiment group,40 in each; routine open surgery was performed on patients in control group while laparoscopy combined with duodenoscope surgery was performed on patients in experiment group; the curative effect,immune function and complication occurrence of the patients in both groups were observed.Results There existed no obvious difference in the time length of surgery between the 2 groups（P〉0.05） but there were statistical differences between experiment group and control group in intro-operative bleeding volume [（30.1± 4.7） m L vs（127.5 ± 23.1） m L],the post-operative anal exhaust time [（51.4±13.8） h vs（94.3 ± 16.5） h],the postoperative analgesic utilization rate（17.5% vs 77.5%） and the residual stone rate（7.5% vs 32.5%）（P〈0.05）; no differences in immune function indexes were found between the2 groups before surgery while after surgery,the levels of serum Ig G,Ig M,Ig A,CD3,CD4 and CD4/CD8 of the patients in experiment group were higher and the level of CD8 was lower than those of the patients in control group,the differences were of statistical significance（P 〈0.05）; the complication occurrence in experiment group was 12.5%while that in control group was 37.5%,the difference was obvious（P 〈0.05）.Conclusions Laparoscopy combined with duodenoscope surgery is of obvious effect in the treatment of elderly patients with gallstones,it can protect the immune function,reduce the complication occurrence,and it is safe,worthy of wider clinical application.
作者
吴刚
詹毓彦
Wu Gang;Zhan Yuyan(Department of Surgery, Tianyou Hospital Affiliated to Wuhan University of Science and Tech-nology, Wuhan, Hubei Province, 430064, P. R. Chin)
出处
《西南军医》
2018年第3期345-348,共4页
Journal of Military Surgeon in Southwest China
关键词
腹腔镜
十二指肠镜
胆结石
免疫功能
并发症
laparoscopy
duodenoscope
gallstone
immune function
complication
