摘要
目的评价腹腔镜胆囊切除术(LC)治疗急性胆囊炎(AC)并发胆结石患者的预后效果。方法以2019年11月-2021年11月天津市蓟州区中医医院收治的80例AC并发胆结石患者为研究对象,按照随机数字表法分为OC组(40例)与LC组(40例)。OC组行开腹胆囊切除术治疗,LC组行LC治疗,比较两组围术期指标(术中出血量、术后肛门排气时间、术后住院时间)、炎性应激指标[C反应蛋白(CRP)、白介素-6(IL-6)、淀粉酶(AMS)]、免疫功能(淋巴细胞亚群CD3^(+)、CD4^(+))、肝功能[血清总胆红素(TBIL)、天冬氨酸转氨酶(AST)、丙氨酸转移酶(ALT)]、手术并发症发生情况。结果LC组术中出血量少于OC组,且术后肛门排气时间、术后住院时间短于OC组(P<0.05);两组术后CRP、IL-6、AMS水平高于术前,但LC组低于OC组(P<0.05);两组术后CD3^(+)、CD4^(+)低于术前,但LC组高于OC组(P<0.05);两组术后TBIL、AST、ALT水平高于术前,但LC组低于OC组(P<0.05);LC组并发症发生率低于OC组(P<0.05)。结论LC在AC并发胆结石治疗中具有明显优势,其术中出血少、术后恢复快,可减轻机体炎症应激反应,降低手术对肝功能及免疫功能的影响,且术后并发症少。
Objective To evaluate the prognosis of laparoscopic cholecystectomy(LC)in patients with acute cholecystitis(AC)complicated with gallstones.Methods A total of 80 patients with AC complicated with gallstones admitted to Tianjin Jizhou District Hospital of Traditional Chinese Medicine from November 2019 to November 2021 were divided into OC group(40 cases)and LC group(40 cases)according to the random number table method.The OC group was treated with open cholecystectomy,and the LC group was treated with LC.The perioperative indicators(intraoperative blood loss,postoperative anal exhaust time,postoperative hospital stay),inflammatory stress indicators[C-reactive protein(CRP),interleukin-6(IL-6),amylase(AMS)],immune function(lymphocyte subsets CD3^(+),CD4^(+)),liver function[serum total bilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT)],and surgical complications were compared between the two groups.Results The intraoperative blood loss in LC group was less than that in OC group,and the postoperative anal exhaust time and postoperative hospital stay were shorter than those in OC group(P<0.05).The levels of CRP,IL-6 and AMS in the two groups after operation were higher than those before operation,but those in the LC group were lower than those in the OC group(P<0.05).The levels of CD3^(+)and CD4^(+)in the two groups after operation were lower than those before operation,but those in the LC group were higher than those in the OC group(P<0.05).The levels of TBIL,AST and ALT in the two groups after operation were higher than those before operation,but those in the LC group were lower than those in the OC group(P<0.05).The incidence of complications in LC group was lower than that in OC group(P<0.05).Conclusion LC has the advantages of less bleeding and rapid postoperative recovery in the treatment of AC complicated with gallstones.Meanwhile,it can reduce the inflammatory stress response of the body,reduce the impact of surgery on liver function and immune function,and have fewer postoperative c
作者
陈晓东
乔阳波
周伟
CHEN Xiao-dong;QIAO Yang-bo;ZHOU Wei(Department of Surgery,Jizhou District Hospital of Traditional Chinese Medicine,Tianjin 301900,China)
出处
《医学信息》
2023年第6期139-142,共4页
Journal of Medical Information
关键词
急性胆囊炎
胆结石
炎症应激
肝功能
免疫功能
Acute cholecystitis
Gallstones
Inflammatory stress
Liver function
Immune function
