腹腔镜胆囊切除术对患者肝功能及免疫功能的影响

目的探讨腹腔镜胆囊切除术(laparoscopic choecystectomy,LC)对患者肝功能及免疫功能的影响。方法 76例接受胆囊切除术治疗的胆囊良性病变患者中46例行LC者纳入LC组,30例行开腹胆囊切除术(open cholecystectomy,OC)者纳入OC组,比较两组患者术后肝功能及免疫功能的变化。结果两组患者术后1 d血清ALT、AST、TBIL均较术前明显升高,差异有统计学意义(P0.05),两组上述指标在术后1 d比较,差异无统计学意义(P0.05),且术后5 d均恢复至术前水平(P0.05);两组患者术后1 d血清CD3+、CD4+、CD4+/CD8+均较术前明显降低(P0.05),且上述指标OC组低于LC组(P0.05),但术后5 d时LC组与术前比较,差异无统计学意义(P0.05),OC组仍低于术前水平(P0.05)。结论 LC可对患者术后肝功能造成一过性损伤,但不影响患者的恢复,且LC对患者的免疫功能的抑制明显小于OC。

Effect of laparoscopic cholecystectomy on liver and immune function

Objective To investigate the laparoscopic cholecystectomy （LC） on liver and immune function.Methods Seventy-six patients with benign gallbladder disease were divided into LC group （n =46） and open cholecystectomy group （OC,n =30）,the postoperative liver function and immune function were compared.Results On 1 d postoperative,the levels of serum ALT,AST,TBIL were significantly increased compared with before surgery in both groups （P 〈 0.05）,and there were no significant difference between two groups （P 〉 0.05）,and on 5 d postoperative,they returned to the preoperative level （P 〉 0.05） ; on 1 d postoperative,the levels of serum CD3 ^＋,CD4 ^＋,CD4^ ＋/CD8^ ＋ were significantly lower than before the surgery （P 〈 0.05）,and those in the OC group were lower than the LC group （P 〈 0.05）,on the 5 d postoperative,there was no significant difference in the LC group compared with the preoperative with these indicators （P 〉 0.05）,but those in the OC group were remained lower than the preoperative （P 〈0.05）.Conclusion LC can cause a transient liver function damage,but does not affect the patients＇ recovery,and the suppress on immune function of LC is significantly less than the OC.