【摘要】 目的探讨腹腔镜与开腹肝囊肿开窗引流术治疗肝囊肿的临床疗效及对肝功能和免疫功能的影响。方法纳入对象为2015年2月至2017年5月在我院进行治疗的84例肝囊肿患者,随机将患者分为微创组和开放组,每组各42例。微创组行腹腔镜下肝囊肿开窗引流术治疗,对照组行开腹肝囊肿开窗引流术治疗。比较两组手术情况、肝功能情况、T细胞亚群情况及并发症情况。结果微创组在手术时间、住院时间、术中出血量上均优于对照组,组间比较差异存在统计学意义(P<0.05)。术后1周,微创组AST、ALT、TBil及DBil水平均低于对照组,组间比较差异存在统计学意义(P<0.05)。术后1周,微创组CD4+,CD4+/CD8+、CD3+细胞的表达均高于对照组,而CD8+显著低于对照组,组间比较差异存在统计学意义(P<0.05)。两组术后并发症方面比较没有明显差别,不存在统计学意义(P>0.05)。结论与开腹手术相比腹腔镜下肝囊肿开窗引流术对患者创伤小,可有效促进患者术后恢复快,降低肝功能指标和提高机体免疫功能,值得临床推广应用。更多还原

【Abstract】 Objective To investigate the clinical effect of laparoscopy and open window drainage on hepatic cyst and its effect on liver function and immune function. Methods The patients included were 84 liver cyst patients treated in our hospital from February 2015 to May 2017. The patients were randomly divided into micro-invasive group and open group, 42 cases each. Laparoscopic openwindow drainage for hepatic cyst was performed in the microinvasive group, while in the control group, open-window drainage was performed. The operation, liver function, T cell subsets and complications were compared. Results The minimally invasive group was superior to the control group in the operation time, the time of hospitalization and the amount of bleeding in the operation, and there was a statistically significant difference between the groups(P<0.05). 1 weeks after the operation, the levels of AST, ALT, TBil and DBil in the minimally invasive group were lower than those in the control group, and there was a statistically significant difference between the groups(P<0.05). At 1 weeks after operation, the expression of CD4+, CD4+/CD8+ and CD3+ cells in the minimally invasive group was higher than that in the control group, while CD8+ was significantly lower than that in the control group, and the difference between the two groups was statistically significant(P<0.05). There was no significant difference in the postoperative complications between the two groups, and there was no statistical significance(P>0.05). Conclusion Compared with open surgery, fenestration and drainage of liver cyst under laparoscopy is effective for patients with less trauma, faster recovery, lower liver function and immune function. It is worthy of clinical application.更多还原