医学信息
醫學信息
의학신식
MEDICAL INFORMATION
2014年
36期
19-20
,共2页
顾汝军%刘冬良%庄彬武%孙刚
顧汝軍%劉鼕良%莊彬武%孫剛
고여군%류동량%장빈무%손강
腹腔镜胆囊切除术%剖腹胆囊切除术%高血压%CRP%IL-6%IL-10
腹腔鏡膽囊切除術%剖腹膽囊切除術%高血壓%CRP%IL-6%IL-10
복강경담낭절제술%부복담낭절제술%고혈압%CRP%IL-6%IL-10
Laparoscopic cholecystectomy%Open cholecystectomy%Hypertension%CRP%IL-6%IL-10
目的观察剖腹与腹腔镜胆囊切除术对于高血压患者免疫功能的影响。方法将90例慢性胆囊炎、胆囊结石伴高血压患者随机分为腹腔镜胆囊切除组(LC)和剖腹胆囊切除组(OC)。术前和术后24、72 h采集外周静脉血，评估术后用视觉模拟评分(VAS)，测定C-反应蛋白(CRP)、白介素6(IL-6)及白介素10(IL-10)。结果 LC组患者术后4、24、72 h的VAS评分均低于OC组(<0.05)。两组患者术前CRP、IL-6和IL-10术前无明显差异(>0.05)，而术后24 h均有显著增多(<0.05)，且OC组CRP、IL-6和IL-10水平均高于LC组。术后72 h LC组及OC组CRP、IL-6和IL-10均有所下降，且LC组CRP、IL-6和IL-10均降至术前水平(>0.05)，而OC组72 h时CRP、IL-6和IL-10对比术前和OC术后72 h组均增多(<0.05)。结论与OC相比，LC对高血压患者可能通过小的手术创伤，使创口局部细胞因子释放减少，进而减少痛觉信息从外周传入中枢神经系统。
目的觀察剖腹與腹腔鏡膽囊切除術對于高血壓患者免疫功能的影響。方法將90例慢性膽囊炎、膽囊結石伴高血壓患者隨機分為腹腔鏡膽囊切除組(LC)和剖腹膽囊切除組(OC)。術前和術後24、72 h採集外週靜脈血，評估術後用視覺模擬評分(VAS)，測定C-反應蛋白(CRP)、白介素6(IL-6)及白介素10(IL-10)。結果 LC組患者術後4、24、72 h的VAS評分均低于OC組(<0.05)。兩組患者術前CRP、IL-6和IL-10術前無明顯差異(>0.05)，而術後24 h均有顯著增多(<0.05)，且OC組CRP、IL-6和IL-10水平均高于LC組。術後72 h LC組及OC組CRP、IL-6和IL-10均有所下降，且LC組CRP、IL-6和IL-10均降至術前水平(>0.05)，而OC組72 h時CRP、IL-6和IL-10對比術前和OC術後72 h組均增多(<0.05)。結論與OC相比，LC對高血壓患者可能通過小的手術創傷，使創口跼部細胞因子釋放減少，進而減少痛覺信息從外週傳入中樞神經繫統。
목적관찰부복여복강경담낭절제술대우고혈압환자면역공능적영향。방법장90례만성담낭염、담낭결석반고혈압환자수궤분위복강경담낭절제조(LC)화부복담낭절제조(OC)。술전화술후24、72 h채집외주정맥혈，평고술후용시각모의평분(VAS)，측정C-반응단백(CRP)、백개소6(IL-6)급백개소10(IL-10)。결과 LC조환자술후4、24、72 h적VAS평분균저우OC조(<0.05)。량조환자술전CRP、IL-6화IL-10술전무명현차이(>0.05)，이술후24 h균유현저증다(<0.05)，차OC조CRP、IL-6화IL-10수평균고우LC조。술후72 h LC조급OC조CRP、IL-6화IL-10균유소하강，차LC조CRP、IL-6화IL-10균강지술전수평(>0.05)，이OC조72 h시CRP、IL-6화IL-10대비술전화OC술후72 h조균증다(<0.05)。결론여OC상비，LC대고혈압환자가능통과소적수술창상，사창구국부세포인자석방감소，진이감소통각신식종외주전입중추신경계통。
Objective To investigate the ef ect of laparoscopic cholecystectomy (LC)and open cholecystectomy (OC)on the immune function in patients with hypertension.Methods Fifty patients with cholecystolithiasis were randomly divided into two groups:LC and (OC).Peripheral blood samples were obtained during the preoperative day and 1,3 day after operation.Serum cytokines levels (IL-6,IL-10)and C-reactive protein(CRP)were measured.Results Changes of IL-6,IL-10 and CRP before surgery in both groups showed no significant dif erence( >0.05).Serum concentrations of CRP,IL-6 and IL-10 on 1d after surgery in both groups were significantly higher than those before surgery (P<0.05);furthermore,the concentrations of CRP,IL-6 and IL-10 in OC group were significantly higher than those in LC group.Serum concentrations of CRP,IL-6 and IL-10 on 3d after surgery in LC groups were not significantly higher than those before surgery( >0.05);however,the concentrations of CRP,IL-6 and IL-10 in OC group on 3d after surgery were significantly higher than those in LC group and those before surgery in OC group ( <0.05).Conclusion It was indicated that the influence of laparoscopic cholecystectomy on the immune function was less to the patients with hypertension than open cholecystectomy.
