腹腔镜胆囊切除术对急性结石性胆囊炎患者炎症反应、免疫功能及近期生活质量的影响

目的探讨腹腔镜胆囊切除术对急性结石性胆囊炎患者炎症反应、免疫功能及近期生活质量的影响。方法回顾性分析2017年6月至2019年5月于我院普外科接受开腹胆囊切除术(对照组,40例)与腹腔镜胆囊切除术(观察组,40例)的急性结石性胆囊炎患者的临床资料。比较两组的治疗效果。结果观察组的手术时间短于对照组,术中出血量少于对照组(P<0.05)。术后12、24、36、48 h,观察组的VAS评分均低于对照组(P<0.05)。术后第1~3天,观察组的C反应蛋白、白细胞介素-6水平均低于对照组(P<0.05)。术后,观察组的CD3+、CD4+/CD8+均高于对照组(P<0.05)。观察组的术后并发症总发生率低于对照组(P<0.05)。观察组的生理领域、心理领域、环境领域、社会关系领域评分均高于对照组(P<0.05)。结论腹腔镜胆囊切除术用于急性结石性胆囊炎患者中具有微创性的优点,可切实减少术中出血量,减轻术后疼痛感和炎症反应,保护免疫功能,有利于减少术后并发症的发生,提高近期生活质量。

Effects of laparoscopic cholecystectomy on inflammatory response,immune function and short-term quality of life in patients with acute calculous cholecystitis

Objective To investigate the effects of laparoscopic cholecystectomy on inflammatory response,immune function and short-term quality of life in patients with acute calculous cholecystitis.Methods The clinical data of patients with acute calculous cholecystitis who underwent open cholecystectomy(control group,40 cases)and laparoscopic cholecystectomy(observation group,40 cases)in general surgery department of our hospital from June 2017 to May 2019 were retrospectively analyzed.The treatment effects of the two groups were compared.Results The operation time of the observation group was shorter than that of the control group,the intraoperative blood loss was less than that of the control group(P<0.05).At 12,24,36,and 48 hours after surgery,the VAS scores in the observation group were lower than those in the control group(P<0.05).The levels of C-reactive protein and interleukin-6 in the observation group were lower than those in the control group on the 1 to 3 days after operation(P<0.05).After surgery,the CD3+and CD4+/CD8+in the observation group were higher than those in the control group(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).The scores in the physical,psychological,environmental and social relations areas of the observation group were higher than those of the control group(P<0.05).Conclusion Laparoscopic cholecystectomy has minimally invasive advantages for patients with acute calculous cholecystitis.It can actually reduce the intraoperative blood loss,decrease postoperative pain and inflammation response,protect immune function,help reduce postoperative complications and improve short-term quality of life.