摘要
目的:探究腹腔镜胆囊切除术对肝硬化合并胆囊结石患者凝血酶原时间(PT)、手术相关指标及并发症的影响。方法:以本院2017年8月至2018年8月收治的84例肝硬化合并胆囊结石患者为研究对象,将患者随机分为两组,对照组42例行传统开腹胆囊切除术;观察组42例行腹腔镜胆囊切除术,比较两组患者手术相关指标、PT、肝功能指标、炎性因子变化及并发症发生情况。结果:观察组患者手术时间、术中出血量、排气及住院时间均明显少于对照组(P<0.05);术后1 d观察组患者凝血酶时间(TT)、PT较对照组高(P<0.05),术后3 d的TT、PT在两组间无统计学意义(P>0.05),而术后1 d、术后3 d活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)均较对照组低(P<0.05);术后1 d、及3 d观察组患者总胆红素(TBil)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)均较对照组低(P<0.05);术后1 d及3 d观察组患者C反应蛋白(CRP)、白细胞介素-6(IL-6)水平均较对照组低(P<0.05);观察组患者并发症发生率为7.14%,明显低于对照组的30.95%(P<0.05)。结论:肝硬化合并胆囊结石患者采用腹腔镜胆囊切除术具有手术时间短、创伤小等优点,对凝血功能、肝功能影响较小,炎症应激反应轻,适合临床推广应用。
Objective:To explore the effects of laparoscopic cholecystectomy on operative related indexes, prothrombin time(PT) and complications in patients with liver cirrhosis and cholecystolithiasis. Methods:Total of 84 patients with liver cirrhosis and cholecystolithiasis admitted to our hospital from August 2017 to August 2018 were selected as the research objects, the patients were randomly divided into control group and observation group, the control group received traditional open cholecystectomy and the observation group received laparoscopic cholecystectomy, the operative related indexes, coagulation function indexes, liver function indexes, inflammatory factors and complications were compared. Results:The operation time, intraoperative bleeding volume, exhaust time and hospitalization time of the observation group were significantly shorter than those of the control group(P<0.05);thrombin time(TT) and PT in the observation group were higher than those in the control group at 1 day after operation(P< 0.05), there was no significant difference in TT and PT between the two groups at 3 days after operation(P>0.05), activated partial thrombin time(APTT) and fibrinogen(FIB) were lower than those of the control group at 1 day and 3 days after operation(P<0.05);the total bilirubin(TBIL), alanine aminotransferase(ALT) and aspartate aminotransferase(AST) in the observation group were lower than those in the control group at 1 day and 3 days after operation(P<0.05);the levels of C-reactive protein(CRP) and interleukin-6(IL-6) in the observation group were lower than those in the control group at 1 day and 3 days after operation(P<0.05);the incidence of complications in the observation group was 7.14%, which was significantly lower than 30.95% in the control group(P<0.05). Conclusion:Laparoscopic cholecystectomy for patients with liver cirrhosis and cholecystolithiasis has the advantages of shorter operation time, less trauma, less influences on coagulation function and liver function, less inflammatory stress response, and
作者
许传波
刘春林
于海涛
殷向华
刘磊
王玉彬
XU Chuan-bo;LIU Chun-lin;YU Hai-tao(Hepatobiliary surgery,the people's Hespital of west coast new area of Qingdao,Qingdao Shandong,266400,China)
出处
《中西医结合肝病杂志》
CAS
2019年第6期520-522,共3页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
关键词
腹腔镜胆囊切除术
肝硬化
胆囊结石
凝血功能
并发症
Laparoscopic cholecystectomy
Liver cirrhosis
Gallbladder stones
Coagulation function
Complications
