摘要
目的探讨腹腔镜和开腹胆囊切除术治疗急性结石性胆囊炎后对胃肠功能和CRP的影响。方法将80例急性结石性胆囊炎行胆囊切除术患者，随机分为两组：腹腔镜组：40例行腹腔镜胆囊切除术；开腹组：行开腹胆囊切除术。对两组患者术后进行胃肠功能评价和CRP检测，进行对比分析。结果急性结石性胆囊炎术后胃肠功能评价：腹腔镜组40例患者，Ⅰ级8例占20．0％、Ⅱ级15例占37．5％、Ⅲ级17例占42．5％；开腹组40例患者，Ⅰ级5例占12．5％、Ⅱ级13例占32．5％、Ⅲ级22例占55．0％。急性结石性胆囊炎术后CRP检测评价：腹腔镜组40例患者，正常6例占15．0％、轻度升高11例占27．5％、中度升高16例占40．0％、重度升高7例占17．5％；开腹组40例患者，正常2例占5．0％、轻度升高13例占32．5％、中度升高14例占35．0％、重度升高11例占27．5％。结论腹腔镜手术时间明显低于开腹手术，避免了开腹后腹腔脏器的暴露，有利于手术后的胃肠功能快速恢复。腹腔镜手术创伤后较开腹手术机体免疫反应轻。
Objective To evaluate laparoscopic and open cholecystectomy for acute cholecystitis after the impact of gastrointestinal function and CRP. Methods 80 cases of acute cholecystitis and choleeystectomy were randomly divided into two groups. The laparoscopic group：40 underwent laparoscopic choleeystectomy. Laparotomy group：open cholecystectomy. Two groups of patients for evaluation of gastrointestinal function and CRP testing, were analyzed. Results Acute cholecystltis evaluation of gastrointestinal function. Laparoscopic group of 40 patients, Ⅰ grade 8 cases accounted for 20.0% , Ⅱ grade 15 cases accounted for 37.5% , Ⅲ grade 17 cases accounted for 42. 5%. Laparotomy group of 40 patients, Ⅰ 5 cases accounted for 12. 5%, Ⅱ, 13 cases accounted for 32. 5%, Ⅲ grade 22 cases accounted for 55.0%. Postoperative acute eholecystitis CRP test rat- ing：laparoscopic group of 40 patients, normal in 6 cases accounted for 15.0% , slightly increased in 11 cases accounted for 27.5% , 40. 0% moderately elevated in 16 cases, severe increase of 7 cases 17.5%. Open group, 40 patients, normal in 2 cases（5. 0% ）, slightly increased in 13 cases（32. 5% ）, 35.0% moderately elevated in 14 cases, 11 cases of severe increased 27. 5%. Conclusion The laparoscopic operation time was significantly lower than open surgery, avoiding the abdominal organs after abdominal exposure is conducive to rapid postoperative recovery of gastrointestinal function. Laparoscopy post-traumatic immune response than open surgery light.
出处
《中国临床实用医学》
2010年第12期20-21,共2页
China Clinical Practical Medicine
