摘要
目的:探讨经脐单孔与常规腹腔镜胆囊切除术(LC)对结石性胆囊炎患者肠胃功能、肝功能及免疫学指标的影响。方法:选取2016年3月~2019年12月间我院收治的157例结石性胆囊炎患者,根据手术方式分为三孔组(n=85,常规三孔LC治疗)和单孔组(n=72,单孔LC治疗),比较两组围术期指标、肠胃功能、肝功能及免疫学指标,并记录两组并发症发生情况。结果:单孔组住院时间短于三孔组,视觉疼痛模拟量表(VAS)评分低于三孔组(P<0.05),单孔组手术时间长于三孔组(P<0.05),两组术中失血量比较无差异(P>0.05)。单孔组肠鸣音恢复时间、肛门排气时间、排便时间、进食时间短于三孔组(P<0.05)。两组术后1 d谷氨酰基转移酶(GGT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)水平均升高,但单孔组低于三孔组(P<0.05)。两组术后1 d免疫球蛋白M(Ig M)、免疫球蛋白A(Ig A)、CD3^(+)、CD4^(+)/CD8^(+)均降低,但单孔组高于三孔组(P<0.05)。两组术后并发症发生率对比,差异未见统计学意义(P>0.05)。结论:与常规三孔LC相比,经脐单孔LC治疗结石性胆囊炎,可有效减轻对机体肝功能、免疫学的影响,促进肠胃功能改善,减轻术后疼痛感,缩短住院时间。
Objective:To investigate the effects of transumbilical single port and conventional laparoscopic cholecystectomy(LC)on gastrointestinal function,liver function and immunological indexes in patients with calculous cholecystitis.Methods:157 patients with calculous cholecystitis who were treated in our hospital from March 2016 to December 2019 were selected,and they were divided into three hole group(n=85,treated with conventional three hole LC)and single hole group(n=72,treated with single hole LC)according to the operation mode.The perioperative indexes,gastrointestinal function,liver function and immunological index of the two groups were compared,and the incidence of complications in the two groups was recorded.Results:The length of stay in the single hole group was shorter than that in the three hole group,the visual analogue scale(VAS)score was lower than that in the three hole group(P<0.05),and the operation time in the single hole group was longer than that in the three hole group(P<0.05).There was no difference in intraoperative blood loss between the two groups(P>0.05).The recovery time of bowel sounds,anal exhaust time,defecation time and eating time in the single hole group were shorter than those in the three hole group(P<0.05).The levels of glutamyl transferase(GGT),aspartate aminotransferase(AST)and total bilirubin(TBIL)in the two groups increased 1 day after operation,but the levels in the single well group were lower than those in the three hole group(P<0.05).The levels of immunoglobulin M(Ig M),immunoglobulin A(IGA),CD3^(+),CD4^(+)/CD8^(+)in the two groups were significantly lower than those in the three well group(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:Compared with the conventional three port LC,transumbilical single port LC in the treatment of calculous cholecystitis can effectively reduce the impact on liver function and immunology,promote the improvement of gastrointestinal function,reduce postoperat
作者
王东阳
林琳
赵永洋
娄熙彬
叶玉祥
WANG Dong-yang;LIN Lin;ZHAO Yong-yang;LOU Xi-bin;YE Yu-xiang(Department of General Surgery,The 900th Hospital of Joint Service Support Force of Chinese People's Liberation Army,Fuzhou,Fujian,350001,China)
出处
《现代生物医学进展》
CAS
2021年第18期3507-3510,3506,共5页
Progress in Modern Biomedicine
基金
福建省卫生系统中青年骨干人才培养项目(2014-ZQNJC-37)。
关键词
经脐单孔
腹腔镜胆囊切除术
结石性胆囊炎
肠胃功能
肝功能
免疫学指标
Transumbilical single port
Laparoscopic cholecystectomy
Calculous cholecystitis
Gastrointestinal function
Liver function
Immunological index
