Clinical efficacy of different surgical methods in the treatment of cholecystolithiasis combined with choledocholithiasis and its effect on immune function / 中国基层医药

ABSTRACT

Objective To compare the clinical efficacy of different surgical methods in the treatment of cholecystolithiasis combined with choledocholithiasis,and its effect on immune function. Methods From December 2009 to February 2017,93 patients with cholecystolithiasis combined with choledocholithiasis in Rongjun Hospital and the First Hospital of Jiaxing,were divided into the observation group and the control group according to random number table method. The observation group(47 cases) was given laparoscope combined surgery,and the control group(46 cases) was given conventional laparotomy surgery. The immune function,pain condition,complete stone clearance rate and analgesics use rate of the two groups were compared. Results After treatment,the CD +4 / CD +8 , CD +4 ,CD +8 ,CD +3 in the observation group were (1. 39 ± 0. 36),(40. 12 ± 8. 70)％ ,(22. 62 ± 2. 22)％ ,(56. 77 ± 3. 47)％ ,respectively,which were significantly lower than those in the control group[(1. 70 ± 0. 40),(46. 00 ± 9. 00)％ ,(25. 00 ± 2. 11)％ ,(60. 00 ± 4. 40)％ ],and the differences were statistically significant (t = 3. 93,3. 20, 5. 30,3. 93,all P < 0. 05). The use rate of analgesics in the observation group (4. 26％ ) was significantly lower than that in the control group (21. 74％ ) (χ2 = 6. 32,P < 0. 05). The complete stone clearance rate of the observation group(95. 74％ ) was significantly higher than that of the control group (80. 43％ ) (χ2 = 5. 22,P < 0. 05). After treatment for 3d,7d,14d,the VAS scores of the observation group were (3. 60 ± 1. 20)points,(2. 57 ± 1. 60)points, (0. 60 ± 0. 06) points, respectively, which were significantly lower than those of the control group [(5. 20 ± 2. 22)points,(4. 12 ±2. 30)points,(2. 77 ±1. 30)points],and the differences were statistically significant (t = 4. 31, 3. 77,11. 31,all P < 0. 05). Conclusion For the patients with cholecystolithiasis combined with choledocholithiasis, laparoscope combined surgery has better clinical efficacy,it can significantly improve the patients' immune function and reduce pain.