腹腔镜胆囊切除术治疗结石性胆囊炎的临床效果观察

目的 探讨腹腔镜胆囊切除术和传统开腹术治疗结石性胆囊炎疗效及对患者免疫功能影响。方法 选取我院2013年6月~2017年6月我院收治的结石性胆囊炎患者90例，根据随机数字表法分为观察组和对照组，每组45例。对照组采用传统开腹手术治疗，观察组采用腹腔镜胆囊切除术治疗，观察两组患者术中出血量、手术时间、胃肠功能恢复时间、住院时间、术后并发症情况，并比较两组患者血清炎性因子和免疫球蛋白水平。结果 观察组患者术中出血量、胃肠功能恢复时间、住院时间均少于对照组，差异有统计学意义（P＜0.05）。治疗后，两组患者血清炎性因子水平均上升，但观察组患者CRP、IL-6、TNF-α上升程度低于对照组（P＜0.05）；治疗后，两组患者免疫球蛋白水平均下降，但观察组患者IgA、IgG、IgM下降程度低于对照组，差异有统计学意义（P＜0.05）。观察组患者术后并发症发生率为4.44%，低于对照组的15.56%，差异有统计学意义（P＜0.05）。结论 相比于传统开腹手术，腹腔镜胆囊切除术可减少术中出血量，缩短结石性胆囊炎恢复时间和住院时间，对患者炎症反应、免疫功能影响较小，安全性较高。

Clinical Observation of Laparoscopic Cholecystectomy for Calculus Cholecystitis

Objective To investigate the effect of laparoscopic cholecystectomy and traditional laparotomy on calculus cholecystitis and its effect on immune function. Methods 90 patients with calculus cholecystitis admitted to our hospital from June 2013 to June 2017 were enrolled. According to the random number table method, they were divided into observation group and control group, with 45 cases in each group. The control group was treated with conventional open surgery. The observation group was treated with laparoscopic cholecystectomy. The intraoperative blood loss, operation time, gastrointestinal function recovery time, hospitalization time and postoperative complications were observed. Patients with serum inflammatory factors and immunoglobulin levels. Results The intraoperative blood loss, gastrointestinal function recovery time and hospitalization time were lower in the observation group than in the control group,the difference was statistically significant (P<0.05). After treatment, serum inflammatory factors increased in both groups, but the increase in CRP, IL-6, and TNF-α in the observation group was lower than that in the control group (P<0.05). After treatment, the immunoglobulin levels in the two groups were treated decreased, but the decrease of IgA, IgG and IgM in the observation group was lower than that in the control group,the difference was statistically significant (P<0.05). The incidence of postoperative complications in the observation group was 4.44%, which was lower than that in the control group 15.56%, the difference was statistically significant (P<0.05).Conclusion Compared with traditional open surgery, laparoscopic cholecystectomy can reduce intraoperative blood loss, shorten the recovery time and hospitalization time of calculous cholecystitis, and have less impact on patients' inflammatory response and immune function, and have higher safety.