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[1]关 旭,赵仲明,祝 进,等.腹腔镜与开腹胆囊切除术对胆囊良性病变患者肝脏和免疫功能影响的比较[J].宁夏医科大学学报,2018,(08):907-910,923.[doi:10.16050/j.cnki.issn1674-6309.2018.08.009]
 GUAN Xu,ZHAO Zhongming,ZHU Jin,et al.Effects of Laparoscopic Cholecystectomy and Open Cholecystectomy on Liver and Immune Function in Patients with Benign Gallbladder Disease[J].Ningxia Medical University,2018,(08):907-910,923.[doi:10.16050/j.cnki.issn1674-6309.2018.08.009]
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腹腔镜与开腹胆囊切除术对胆囊良性病变患者肝脏和免疫功能影响的比较(PDF)
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《宁夏医科大学学报》[ISSN:1005-8486/CN:64-1029/R]

卷:
期数:
2018年08期
页码:
907-910,923
栏目:
论著
出版日期:
2018-08-30

文章信息/Info

Title:
Effects of Laparoscopic Cholecystectomy and Open Cholecystectomy on Liver and Immune Function in Patients with Benign Gallbladder Disease
文章编号:
1674-6309(2018)08-0907-04
作者:
关 旭 赵仲明 祝 进 赵经川 闫海燕 牛孜耕
(宁夏银川市第二人民医院普通外科,银川 750011)
Author(s):
GUAN Xu ZHAO Zhongming ZHU Jin ZHAO Jingchuan YAN Haiyan NIU Zigeng
(Department of General Surgery,Yinchuan Second People's Hospital,Yinchuan 750011)
关键词:
胆囊良性病变腹腔镜开腹胆囊切除术免疫功能肝功能
Keywords:
benign lesions of gallbladder laparoscopy laparotomy cholecystectomy immune functionliver function
分类号:
R657.4
DOI:
10.16050/j.cnki.issn1674-6309.2018.08.009
文献标志码:
A
摘要:
目的 比较腹腔镜胆囊切除手术(laparoscopy cholecystectomy,LC)和开腹胆囊切除手术(open cholecystectomy,OC)对胆囊良性病变患者机体肝功能和免疫功能的影响。方法 2013年1月至2015年12月收治胆囊良性病变患者80例,其中胆囊结石25例,胆囊息肉25例,慢性胆囊炎30例。采用LC治疗的为LC组,采用OC治疗的为OC组,每组40例。分析两组患者术前、术后第1天及术后1周的肝功能及相关免疫指标的改变。结果 术后第1天两组的谷氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和血清总胆红素(TBIL)均高于术前(P均<0.05),LC组TBIL低于OC组(P<0.05);术后第7天,ALT和AST均恢复到术前水平,TBIL均仍高于术前(P<0.05),但低于术后第1天(P均<0.05),且LC组低于OC组(P均<0.05)。两组术后第1天与术前相比,CD3+T和CD4+T均低于术前(P<0.05),而CD8+T高于术前(P<0.05);两组术后第7天,3项指标均恢复到术前水平,术后第7天 CD3+T、CD4+T、CD8+T均高于术后第1天(P<0.05);术后第1天的 IL-8及C反应蛋白(CRP)较术前均升高(P均<0.05),LC组IL-8低于OC组(P<0.05),术后第7天的CRP和IL-8比术前和术后第1天高(P均<0.05)。且LC组CRP低于OC组(P<0.05)。术后第1天LC组IL-6低于OC组(P<0.05)。LC组患者的出血量和住院时间均低于OC组(P均<0.01)。结论 腹腔镜胆囊切除手术对胆囊良性病变患者的肝功能和免疫功能影响小。
Abstract:
Objective To compare the influence of liver function and immunologic function in patients with benign lesion of the gallbladder receiving laparoscopic cholecystectomy(LC)versus open cholecystectomy(OC).Methods From January 2013 to December 2015,80 cases of patients with benign lesion of the gallbladder including 25 cases of gallstone,25 cases of Gallbladder polyps,30 cases of chronic cholecystitis in our hospital were chosen and divided into LC group(40 cases) and OC group(40 cases). The LC group was treated with LC and the OC group was treated with OC. The liver function,immunologic function and inflammatory factor of the two groups were compared 1d before operation,1d and 7d after operation. Results The level of ALT,AST,TBIL were significantly increased 1d after operation when compared with those of pre-operation in two groups(P<0.05). On day 7 after operation the level of ALT and AST recovered near to those of ld before operation, but TBIL levels were still higher than those of pre-operation(P<0.05),less than those of 1d post-operation(P<0.05). Furthermore,the three indexes in LC group were higher than those in OC group on the 7th day after operation. The levels of CD3+ and CD4+ 1d after operation were significantly decreased whereas the levels of CD8+ were significantly increased in two groups compared with those of pre-operation(P<0.05). And the levels of CD4+ were obviously decreased in LC group compared with those in OC group, at the same time the levels of CD8+ were significantly elevated in OC group compared with those in LC group(P<0.05). On the 7th day after operation the three index recovered to the levels of the pre-operation,but were still higher than those of 1d post-operation(P<0.05). There were no differences between each group on 7th day after operation(P>0.05). The levels of IL-6,IL-8 and CRP were significantly increased on 1d after operation compared with those of pre-operation(P<0.05) as well as the levels of IL-8 in OC group were higher than those in LC group(P<0.05). The levels of IL-8 and CRP on the 7th day of post-operation were still significantly increased when compared with those of pre-operation and 1d post-operation(P<0.05). Moreover the level of CRP in OC group was higher than that in LC group(P<0.05). The level of IL-6 was obviously decreased when compared with that of 1d post-operation and less in LC group than that in OC group(P<0.05). Amount of bleeding and hospital stays in LC group was obviously lower than OC group(P<0.05). Conclusion LC has little influence on the liver and immunologic function of the patients,showing the advantage of minimal invasiveness with a safety and reliability. Therefore,it could be widely recommended in the clinic as a minimally invasive surgery.

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备注/Memo

备注/Memo:
收稿日期:2017-10-28
基金项目:宁夏自然科学基金(NZ15229)
作者简介:关旭,副主任医师,从事普外科的临床工作及研究。
更新日期/Last Update: 2018-08-30