摘要
目的探究单孔腹腔镜胆囊切除术(LC)对胆囊结石患者应激反应及术后并发症的影响.方法选取本院2020年6月—2022年6月收治的106例胆囊结石患者,按随机数字表法分为对照组、观察组,每组53例.对照组采用传统三孔LC治疗,观察组采用单孔LC治疗.对比两组的手术相关指标、肝功能、应激反应及并发症发生情况.结果观察组的术中出血量少于对照组,术后排气时间、住院时间均短于对照组,手术切口小于对照组,术后3d疼痛视觉模拟评分低于对照组,手术时间长于对照组,组间差异有统计学意义(P<0.05).术后24 h,观察组的促肾上腺皮质激素、α_(1)抗胰蛋白酶、C反应蛋白水平分别为(23.26±6.30)pg/mL、(1.42±0.24)g/L、(18.22±2.31)mg/L,均低于对照组,组间差异有统计学意义(P<0.05).术后24 h,观察组的丙氨酸氨基转移酶、天门冬氨酸转氨酶、血浆皮质醇水平分别为(39.90±3.27)U/L、(32.14±2.16)U/L、(14.99±2.20)μg/dL,均低于对照组,组间差异有统计学意义(P<0.05).观察组的并发症发生率较对照组低,但差异无统计学意义(P>0.05).结论与传统三孔LC治疗比较,单孔LC能有效减轻胆囊结石患者的应激反应,改善其肝功能,缩小切口,减少术中出血量,促进术后恢复,且并发症相对较少.
Objective To investigate the effect of single hole laparoscopic cholecystectomy(LC)on stress response and postoperative complications in patients with cholecystolithiasis.Methods A total of 106 patients with cholecystolithiasis admitted to the hospital from June 2020 to June 2022 were selected and were divided into a control group and an observation group according to random number table,with 53 cases in each group.The control group was treated with traditional three holes LC,and the observation group was treated with single hole LC.The operation related indexes,liver function,stress response and complications were compared between the two groups.Results The intraoperative blood loss in the observation group was less than that in the control group,the postoperative exhaust time and hospital stay were shorter than those in the control group,the surgical incision was less than that in the control group,the pain analogue scale score 3 days after the operation was lower than that in the control group,and the operative time was longer than that in the control group,the differences between the groups were statistically significant(P<0.05).24 h after surgery,the levels of corticotropin,α_(1) antitrypsin and C-reactive protein in the observation group were(23.26±6.30)pg/mL,(1.42±0.24)g/L and(18.22±2.31)mg/L,respectively,which were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).24 h after surgery,the levels of alanine aminotransferase,aspartate aminotransferase and plasma cortisol in the observation group were(39.90±3.27)U/L,(32.14±2.16)U/L and(14.99±2.20)μg/dL,respectively,which were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,but there was no statistical significance(P>0.05).Conclusion Compared with traditional three holes LC treatment,single hole LC can effectively reduce the stress response of patients with cholecystolithiasis,improve liver function,narrow incision,reduce intraoperative blood loss,and promote postoperative recovery,with relatively few complications.
作者
曹峰
刘敏
李云龙
CAO Feng;LIU Min;LI Yunlong(Department of General Surgery,Wuxi Huishan District Second People's Hospital,Wuxi Jiangsu,214000,China;Operating Room,Wuxi Huishan District Second People's Hospital,Wuxi Jiangsu,214000,China)
出处
《反射疗法与康复医学》
2022年第23期85-88,共4页
Reflexology And Rehabilitation Medicine
基金
2021年无锡市卫生健康委适宜技术推广项目(T202121)。
关键词
胆囊结石
单孔
腹腔镜胆囊切除术
手术相关指标
肝功能
应激反应
并发症
Cholecystolithiasis
Single hole
Laparoscopic cholecystectomy
Operation related indexes
Liver function
Stress reaction
Complication
