摘要
目的探讨腹腔镜手术对胆结石的临床手术效果,以及对胆结石患者免疫球蛋白、CD4+、CD8+及CD4+/CD8+的影响机制。方法选择2009年3月～2010年4月间在我院行腹腔镜胆结石取石术患者62例,设立为A组,另选择同期行开腹胆结石取石术的60例患者,设立为B组,观察两组患者的手术效果、并发症及免疫球蛋白、CD4+、CD8+及CD4+/CD8+的变化情况。结果与B组比较,A组术中出血量少,肛门排气时间早,术后疼痛轻,术后残石率低,A组术后出现肺部感染、腹部感染、出血及、胆漏和切口愈合不良的例数明显少于B组,两组比较,差异有统计学意义(P<0.05)。A组术前及术后CD4+、CD8+及CD4+/CD8+无明显差异,术后3 d A组淋巴细胞亚群下降较B组少,A组机体免疫球蛋白IgA、IgM、IgG虽有降低,但差异不显著,而B组免疫球蛋白在创伤早期明显减少(P<0.05)。结论腹腔镜手术治疗胆结石手术效果优于开腹手术,具有出血少、恢复快、术后疼痛轻、并发症少等优点,且腹腔镜手术能保护机体的免疫功能,有效减少了术后感染的发生,值得推广和应用。
Objective To explore the clinical efficacy of laparoscopic surgery for gallstones, and futher to analyze the changes of immunoglobulin, CD4＋ and CD8＋ and CD4＋/CD8＋of laparoscopic surgery for gallstones in patients. Methods Selected the laparoscopic gallstone lithotripsy patients 62 cases from March 2009 to April 2010 in our hospital, estab- lished as a Group A, and the other selected the same time open gallstone lithotripsy 60 patients set up for the B group, ef- fect of surgery, complications, and immunoglobulin and CD4＋ and CD8＋ and CD4＋/CD8＋ changes were observed. Results Compared with group B, group A had less blood loss, flatus early postoperative pain, and residual stone ratewas low, group A postoperative pulmonary infection, abdominal infection, bleeding and bile leakage the number of adverse cases and wound healing were significantly less than group B, the difference was significant. Group A preoperative and postoperative CD4＋, CD8＋ and CD4＋/CD8＋ had no significant difference, in postoperative 3 d A lymphocyte subsets decreased less than in group B, group A immune globulin IgA and IgM, IgG, although lower, but the difference was not significant, while the group B immune globulin in the early trauma significantly reduced（P 〈 0.05）. Conclusion The surgical results of laparoscopic surgery for gallstones is superior to open surgery, less bleeding, faster recovery, postoperative pain, fewer complications, and laparoscopic surgery can protect the immune function, and effective in reducing postoperative infection, worthy of promotion and application.
出处
《中国现代医生》
2012年第18期50-52,共3页
China Modern Doctor
