Effect of Laparoscopic Minimally Invasive Surgery and Open Repair on the Stress Response,Immune Function and Levels of Serum Inflammatory Factors in Elderly Patients with Ulcerous Perforation of Digestive Tract
CHEN Wei-wei;YUAN Xiao-bing;LU Shao-bo;Department of General Surgery,Rugao People's Hospital;
Objective To investigate the effect of laparoscopic minimally invasive surgery and open repair on the stress response,immune function and levels of serum inflammatory factors in elderly patients with ulcerous perforation of digestive tract. Methods 80 cases of elderly patients with ulcerous perforation of digestive tract treated in our hospital from October 2014 to November 2016 were randomly selected and divided into the control group and the experimental group by random number table method,40 cases in each group. The two groups were treated with traditional open repair and laparoscopic minimally invasive surgery,respectively. The operation related indexes,stress response indexes [serum procalcitonin( PCT) ],immune response indexes[T lymphocyte subsets( CD4~+,CD8~+),natural killer cells( NK) ] and serum inflammatory factors[interleukin-1( IL-1),interleukin-6( IL-6),tumor necrosis factor α( TNF-α) ] in the two groups were analysed before and after treatment. Results The hospitalization time of the experimental group was significantly shorter than that of the control group,and the incidence of complications was significantly lower than that in the control group( P 0. 05),but there was no significant difference in the operation time between the two groups( P 0. 05). There was no significant difference in PCT,CD4+,CD8+,NK,IL-1,IL-6 and TNF-α between the two groups before operation( P 0. 05). 1 day after operation,PCT levels in the two groups significantly increased( P 0. 05). There was no significant difference in PCT levels in the experimental group at 2 days and 7 days after operation,compared with those before operation. 1 day and 2 days after operation,PCT levels were significantly lower in the experimental group than those in the control group( P 0. 05). 1 day and 2 days after operation,CD4+,CD8+and NK in two groups significantly decreased,while IL-1,IL-6 and TNF-α significantly increased. After operation,the indexes in experimental group were better than those in the control group( P 0. 05). Conclusion The application of laparoscopic minimally invasive surgery in the treatment of elderly patients with ulcerous perforation of digestive tract can shorten the length of hospital stay and reduce the incidence of postoperative complications. The induced stress response,immune function damage and inflammation are mild.
【CateGory Index】： R656.62