摘要
目的:分析腹腔镜胆囊切除术治疗胆囊结石的疗效及对患者肝功能、免疫功能以及炎症因子水平的影响.方法:收集本院自2015年6月-2018年12月收治的胆囊结石患者197例作为研究对象,按数字奇偶法分为观察组与对照组两组,观察组99例,对照组98例.观察组给予腹腔镜胆囊切除术治疗,对照组给予传统开腹胆囊切除术治疗.记录并比较两组术中及术后指标情况,监测两组肝功能指标谷草转氨酶(AST)、丙氨酸转移酶(ALT)、血清总胆红素(TBIL),免疫功能指标免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG),炎症因子水平肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)、白介素-6(IL-6)变化情况,随访两组远期预后情况.结果:观察组术中及术后情况均明显优于对照组(P<0.05).术前,两组肝功能ALT、AST、TBIL指标水平比较,差异均无统计学意义(P>0.05);术后第1、5天,观察组ALT、AST、TBIL指标水平均明显低于对照组(P<0.05),且观察组肝功能指标趋于正常水平较对照组快(P<0.05).术前,两组免疫功能IgA、IgM、IgG指标水平比较,差异均无统计学意义(P>0.05);术后第1、5天,观察组的IgA、IgM、IgG指标水平均明显高于对照组(P<0.05),且观察组上述指标趋于正常水平较对照组快(P<0.05).术前,两组血清hs-CRP、IL-6及TNF-α水平比较,差异均无统计学意义(P>0.05);术后第1、5天,观察组的血清hs-CRP、IL-6及TNF-α水平均明显低于对照组(P<0.05),且观察组上述指标趋于正常水平较对照组快(P<0.05).观察组总不良预后率为2.02%,明显低于对照组的9.18%(P<0.05).结论:腹腔镜胆囊切除术对患者创伤小,炎症反应轻,免疫功能及肝功能影响小,恢复快,远期预后更满意,安全可靠,具有较高的推广价值.
Objective:To analyze the effect of laparoscopic cholecystectomy on the treatment of cholecystolithiasis and the effect on the liver function,immune function and inflammatory factors.Method:A total of 197 cases of cholecystolithiasis patients admitted to our hospital from June 2015 to December 2018 were collected as the research objects.They were divided into observation group and control group by digital parity method,99 cases in the observation group and 98 cases in the control group.The observation group was treated with laparoscopic cholecystectomy,while the control group was treated with traditional open cholecystectomy.The intraoperative and postoperative general indicators of two groups were recorded and compared.The liver function index of aspartate aminotransferase(AST),alanine transaminase(ALT),serum total bilirubin(TBIL)and immune function index immunoglobulin M(IgM),immunoglobulin A(IgA),immunoglobulin G(IgG),inflammatory factor levels of tumor necrosis factor-α(TNF-α),allergic C-reactive protein(hs-CRP)and interleukin-6(IL-6)of two groups were monitored.The long-term prognosis of two groups was followed up.Result:The observation group was significantly better than the control group(P<0.05).There were no significant differences in ALT,AST and TBIL indexes between the two groups before surgery(P>0.05).On the 1st and 5th day after surgery,ALT,AST and TBIL indexes in the observation group were significantly lower than those in the control group(P<0.05),and liver function indexes in the observation group tended to be normal faster than those in the control group(P<0.05).Before the operation,there were no statistically significant differences in IgA,IgM and IgG indexes of immune function between the two groups(P>0.05).On the 1st and 5th day after the operation,IgA,IgM and IgG indexes of the observation group were significantly higher than those of the control group(P<0.05),and the indexes of the observation group tended to be normal faster than those of the control group(P<0.05).Before surgery,there were
作者
胡海中
纪刚
HU Haizhong;JI Gang(Jingdezhen Changjiang Hospital,Jingdezhen 343009,China)
出处
《中国医学创新》
CAS
2020年第19期30-34,共5页
Medical Innovation of China
关键词
腹腔镜
胆囊切除术
胆囊结石
肝功能
免疫功能
Laparoscopy
Cholecystectomy
Gallbladder stones
Liver function
The immune function
