胆囊切除术所致医源性胆道损伤对机体的影响

齐宏军，翟大勇

（陕西省永寿县人民医院，陕西 咸阳，713400）

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摘要：

目的 探究胆囊切除术所致医源性胆道损伤对机体的影响。方法 选择于我院接受治疗的20例医源性胆道损伤患者，均为胆囊切除术所致。记录全部患者损伤类型及部位，测定并比较手术前后免疫指标、炎症指标、肝功能指标。结果 手术前患者的IgA、IgG、IgM指标测定值分别为（1.23±0.31）g/L，（8.27±0.53）g/L 和（1.05±0.25）g/L，显著低于手术后的（1.36±0.33）g/L、（13.02±0.73）g/L 和（1.37±0.34）g/L（P<0.05）。手术前患者IL-6、IL-10、CRP炎症指标分别为（3.5±0.8）ng/L，（2.7±0.4）ng/L，（16.4±9.2）ng/L，显著低于手术后的（15.8±0.7）ng/L，（40.6±8.9）ng/L，（65.3±14.7）ng/L（P<0.05）。手术后患者ALT、ALP、AST、TBIL 及DBIL 测定值，均显著高于手术前（P<0.05）。结论 胆囊切除术所致医源性胆道损伤可降低患者免疫功能与肝功能，促进炎症反应。

关键词：胆囊切除术；医源性胆道损伤；免疫因子

中图分类号：R657.4 文献标志码：A文章编号：2096-1413(2017)01-0055-02

Influence of iatrogenic bile duct injury to the body caused by cholecystectomy
JI Hong-Jun, ZHAI Da-yong
(Yongshou County People s Hospital, Xianyang 713400, China)

ABSTRACT: Objective To explore the influence of iatrogenic bile duct injury to the body caused by cholecystectomy. Methods Twenty cases of patients with iatrogenic bile duct injury who receive cholecystectomy in our hospital were selected as study objects. The injury types and locations were recorded, and the immune indexes, inflammation index, liver function index were measured and compared before and after surgery. Results The values of IgA, IgG, IgM before the surgery were (1.23±0.31)g/L, (8.27±0.53)g/L, (1.05±0.25)g/L respectively, which were obviously lower than (1.36±0.33)g/L, (13.02±0.73)g/L and (1.37±0.34) g/L after the surgery (P<0.05). The levels of IL-6, IL-10, CRP before the surgery were (3.5±0.8) ng/L, (2.7±0.4) ng/L, (16.4±9.2) ng/L respectively, which were obviously lower than (15.8±0.7) ng/L, (40.6±8.9) ng/L, (65.3±14.7) ng/L after the surgery (P<0.05). The levels of ALT, ALP, AST, TBIL, DBIL after the surgery were significantly higher than those before the surgery (P<0.05). Conclusion Iatrogenic bile duct injury caused by cholecystectomy can reduce the patients  immune function and liver function, also can promote inflammation.
KEYWORDS: cholecystectomy; iatrogenic bile duct injury; immune factors

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