海南医科大学学报

目的:探讨腹腔镜胆囊切除术(LC)对患者肝功能及免疫功能的影响。方法:分析山东省宁津县人民医院2014年12月~2015年12月110例行胆囊切除术患者的临床资料,依据手术方式分为观察组和对照组,观察组采用LC,对照组采用开腹胆囊切除术(OC);于术前1d和术后第1d、第7d抽取清晨空腹静脉血,测定血清免疫球蛋白IgA、IgG、IgM水平,及肝功能血清总胆红素(TBIL)、丙氨酸转移酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转肽酶(GGT),对比观察两组免疫球蛋白及肝功能变化情况。结果:术后第1d两组IgA、IgG、IgM水平较术前1d降低,术后第7d各指标水平恢复趋于术前1d水平,差异有统计学意义(P<0.05);术后相同时间点两组各指标比较差异无统计学意义(P>0.05)。术后第1d两组TBIL、ALT、AST、GGT明显较术前1d升高,术后第7d各指标水平恢复趋于术前1d水平,差异有统计学意义(P<0.05);观察组恢复程度优于对照组,差异有统计学意义(P<0.05)。结论:LC对机体免疫功能及肝功能影响较小,术后恢复快,明显体现了微创的优越性,安全可靠,值得临床推广应用。

Objective:To explore the effect of laparoscopic cholecystectomy(LC)on the liver function and immune function.Methods:A total of 110 patients who were admitted in our hospital from December,2014 to December,2015 for cholecystectomy were included in the study and divided into the observation group and the control group according to different operation Methods:The patients in the observation group were given LC,while the patients in the control group were given open cholecystectomy(OC).The morning fasting venous blood 1dbefore operation,1dand 7dafter operation was extracted to determine the levels of serum immune globulin IgA,IgG,IgM,and liver function indexes TBIL,ALT,AST,and GGT.The changes of immune globulin and liver function in the two groups were observed and compared.Results:The levels of IgA,IgG,and IgM 1dafter operation in the two groups were significantly reduced when compared with 1dbefore operation,and the levels of various indicators 7dafter operation were recovered to the levels 1dbefore operation(P<0.05).The comparison of various indicators at the same timing points after operation between the two groups was not statistically significant(P>0.05).The levels of TBIL,ALT,AST,and GGT 1dafter operation in the two groups were significantly elevated when compared with 1dbefore operation,and the levels of various indicators 7dafter operation were recovered to the levels 1dbefore operation(P<0.05).The recovery degree in the observation group was significantly superior to that in the control group(P<0.05).Conclusions:LC has a small effect on the immune function and liver function,with a rapid postoperative recovery,obviously reflecting the superiority of minimal invasiveness,which is safe and reliable;therefore,it deserves to be widely recommended in the clinic.