腹腔镜胆囊切除术对机体就激反应的影响

目的 研究腹腔镜胆囊切除术对机体应激反应的影响。方法 将70例胆囊炎、胆囊结石患者随机分成腹腔镜胆囊切除组（LC）和开腹胆囊切除组（OC）。术前和术后第1，3，5，7d采集外周静脉血，测定白细胞介素1β（IL-1β），肿瘤坏死因子α（TNF-α），白细胞介素6（IL－6）和C－反应蛋白（CRP）。结果 两组手术前后IL－1β和TNF-α均无明显差异（P＞0．05），两组间手术前后比较也无明显差异（P＞0．05）；两组手术后IL－6第1d升至最高，与术前及术后第3，5，7d比较有高度显著差异（P＜0．01）而术前与术后第3，5，7d比较无显著差异（P＞0．05），两组之间比较亦无显著差异（P＞0．05）；两组手术后CRP第1，3，5d均较术前有明显升高（P＜0．05），以术后第1和第3d升高最明显，而两组之间比较无显著差异（P＞0．05）。结论 LC对机体应激反应与OC相比没有明显差异。

Effect of laparoscopic cholecystectomy on systemic stress response

Objective　To investigate the systemic stress responses of laparoscopic cholecystectomy(LC). Methods　Seventy patients with cholecystolithiasis were randomly divided into two groups: LC and open cholecystectomy(OC). Peripheral blood samples were obtained during the preoperative day and 1, 3, 5, 7 day after operation. Serum cytokines levels (TNF-α, IL-1β and IL-6) and C-reactive protein(CRP) were measured. Results　Changes of TNF-α and IL-1β before or after surgery in both groups showed no significant difference(P>0.05). Serum concentrations of IL-6 and CRP after surgery in both groups were significantly higher than those before surgery(P<0.05); but there were no significant difference between the two groups(P>0.05). Conclusions　The systemic stress responses of LC have no significant difference comparing with OC.