不同手术方法对胆结石患者免疫状态影响研究

目的比较不同手术方法对胆结石患者免疫状态的影响。方法将80例胆结石患者按随机数字表法分为传统组和腹腔镜组，每组40例。分别于术前1d和术后3d抽取外周静脉血检测IgG、IgA、IgM、CD3＋、CD4＋,CD8＋、C3、C4、CD4＋／CD8＋。同时观察手术时间、术中出血量、肠功能恢复时间、住院天数、并发症等临床指标。结果两组均顺利完成手术，腹腔镜组无一例中转开腹。腹腔镜组的手术时间、术中出血量、肠功能恢复时间、住院天数、并发症发生率均低于传统组（P〈0．01）；腹腔镜组术后3d的IgG、IgA、IgM、CD3＋、CD4＋,CD8＋,C3、C4，CD4＋／CD8＋均高于传统组（P〈0．01）。结论与传统开放手术相比，腹腔镜手术治疗胆结石具有手术切口小、术中出血少、术后肠道功能恢复快、住院时间短、对机体免疫功能影响小等特点，体现了腹腔镜胆道手术的微创性。

Effects of Different Operating Methods on the Immune Status of Patients with Gallstones

Objective To compare the effects on the immune status of patients with gallstones by different surgical methods. Meth- ods All of 80 patients with gallstones were randomly divided into the traditional group and the laparoscopic group,40 cases in each group. Peripheral blood samples were collected l d preoperative and 3d postoperative respectively to detect IgG,IgA,IgM,CD3＋,CD4＋, CD8＋,C3,C4,CD4＋/CD8＋. The operative time,blood loss,intestinal function recovery time,hospital stay,complications and other clinical indicators were observed. Results Both groups were successfully operated,and there was no case of conversion to open surgery in la- paroseopic group. Laparoscopic operative time,blood loss,intestinal function recovery time,length of stay,complication rate were lower than that of the conventional group （P〈0.01） respectively. IgG,IgA,IgM,CD3~,CD4＋,CD8~,C3,C4,CD4＋/CD8＋ of laparoscopic surgery 3d after operation were higher than that of the traditional group （P〈0.01）. Conclusion Compared with traditional open surgery,la- paroscopic surgery for gallstones have a small incision,less bleeding,faster recovery of bowel function after surgery,shorter hospital stay, little effect on immune function and other features ,and reflects the laparoscopic minimally invasive for hiliary tract surgery.