Effects of laparoscopic surgery on cellular immune markers and inflammatory mediators in elderly patients with up-per gastrointestinal perforation
YAO Zhengshun
YAN Hong
ZHEN Bo
YU Hongze
LIU Chunyong
Abstract：Objective To investigate the effect of laparoscopic surgery on cellular immune markers and inflammatory mediators in elderly patients with upper gastrointestinal perforation. Methods Ninety-four cases of elderly patients with upper gastrointestinal perforation were selected,which were treated in hospital from June 2014 to June 2017,and they were divided into observation group (47 cases) and control group (47 cases). The patients of two groups were all treated with routine ex-amination and treatment. The patients of control group were treated with traditional open surgery. The patients of observation group were treated with laparoscopic surgery. Compare the general condition of surgery,postoperative 12 h,48 h pain,anal-gesic drug use,adverse reactions and changes of IL 6,CRP,TNF-α,CD3 +,CD4 +,CD8 +levels of two groups. Results The incision length,intraoperative blood loss,operation time,time to bed, gastrointestinal function recovery time, length of stay in the observation group were significantly lower than those in the control group (t= 45.504, t=25.273, t=37.850, t=25.299,t=56.291,t=6.991;P= 0.000,P=0.000,P=0.000,P=0.000,P=0.000,P=0.000). The postoper-ative 12 h,48 h pain VAS score,analgesic use rate in the observation group were significantly lower than those in the control group(t/χ2= 13.385,t/χ2= 8.565,t/χ2=18.729;P= 0.000,P=0.000,P=0.000). On the 7th day after operation, the IL 6,CRP,TNF-α levels in the observation group were significantly lower than those in the control group,and the CD3 +, CD4 +,CD8 +levels in the observation group were significantly higher than those in the control group(t= 6.123,t=4.574, t=1.759,t=5.118, t=5.995, t=7.964; P= 0.000, P=0.000, P=0.041, P=0.000, P=0.000, P=0.000). There were lung infection,incision infection,incisional hernia,gastrointestinal fistula,intestinal obstruction and other adverse reactions occurred in both two groups,and the difference between groups were statistically significant(χ2= 6.075,χ2= 6. 612,χ2=4.080,χ2=4.620; P= 0.014, P=0.010, P=0.043, P=0.043, P=0.032). Conclusion Laparoscopic surgery for the treatment of elderly patients with upper gastrointestinal perforation with small trauma,mild pain,mild cellular immune function and stress response,less complications,which makes it beneficial to the patient's postoperative recovery.
Keywords：Upper gastrointestinal perforationLaparoscopyCellular immunityInflammatory mediatorsElderly pa-tients
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 366-369,373 )