腹腔镜胆囊切除术对机体免疫球蛋白、补体及CRP的影响

目的 :研究腹腔镜胆囊切除术 (LC)和开腹胆囊切除术 (OC)对机体免疫功能的影响。方法 :检测LC 2 0例和OC 18例患者入院次日、术后 2 4h和 4 8h的IgG、IgA、IgM和补体C3、C4 及C 反应蛋白质 (CRP)含量并进行对照研究。结果 :LC组免疫球蛋白及补体水平手术前后无变化 ,OC组术后血清IgG和C3低于术前水平 ,两组间差异无显著性 (P >0 0 5 ) ,但OC组术后下降幅度比LC组大 ,两组间差异有显著性 (P <0 0 5 )。两组术后CRP均明显升高 ,而OC组术后改变明显高于LC组 ,两组间差异有显著性 (P <0 0 1)。结论 :LC和OC术后早期免疫功能均在一定程度上被抑制 ,但LC组的免疫抑制程度较OC组轻 ,恢复快 ,表明LC对机体的创伤较小 ,是微创手术

The influence of laparoscopic cholecystectomy on the human immunoglobulins,complements and C-reactive protein

Objective:To study the influence of open cholecystectomy (OC) and laparoscopic cholecystectomy (LC)on humoral immune.Methods:The changes in humoral immune responses were compared in patients underwent laparoscopic cholecystectomy and open cholecystectomy.Immune parameters including serum immunoglobulins(IgG?IgA?IgM),complements(C 3?C 4)and C reactive protein(CRP)were assessed preoperatively and at 24 and 48 hours postoperative.Results:The levels of serum immunoglobulins and complements did not change after LC(P>0 05),but the levels of serum IgG and C 3 significantly decreased after OC(PWTBZ剑? 05).There was no significant difference between two groups.The levels of serum CRP obviously increased in LC and OC,but the change in the OC group was obviously higher than that in the LC group.There was a significant difference between two groups(WTBX]P<0 01).Conclusions:Both LC and OC can cause a certain degree depression of immune function in the earlier postoperative period.But LC causes less depression of immune function than OC does and the recovery of the immunosuppression in LC group is more quickly than in OC group.That is to say,laparoscopy procedure is less traumatic.