摘要
目的探究Qiaotech硬质胆道镜保胆取石手术与胆囊切除治疗胆囊结石的效果。方法前瞻性选取2020年2月至2021年2月宿迁市中医院收治的103例胆囊结石患者作为研究对象,采用随机信封法将其分为观察组(n=51)和对照组(n=52),观察组行Qiaotech硬质胆道镜保胆取石手术,对照组行常规胆囊切除术。比较两组患者疗效、术后疼痛程度、术前术后血清炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]水平、肝功能指标[天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、总胆红素、总蛋白]及术后并发症发生情况。结果观察组患者住院时间为(4.52±1.92)d,显著短于对照组[(9.31±1.11)d],术中出血量、切口长度、手术时间分别为(25.41±4.94)mL、(2.71±0.94)cm、(44.81±6.81)h,均低于对照组[(48.21±5.23)mL、(5.31±1.11)cm、(57.91±5.21)h],差异均有统计学意义(P<0.05)。观察组术后6、24、48 h VAS评分均低于对照组,差异均有统计学意义(P<0.05)。术后3 d,两组患者血清TNF-α、IL-6、CRP水平均高于术前,且观察组的TNF-α、IL-6、CRP水平(40.71±6.53)ng/L、(33.21±10.12)pg/L、(12.42±3.44)mg/L,均低于对照组[(68.15±10.92)ng/L、(55.14±12.42)pg/L、(24.65±7.77)mg/L],差异均有统计学意义(P<0.05)。观察组胆汁反流性胃炎及腹胀腹泻发生率为1.92%、3.85%,低于对照组(15.69%、17.65%),差异均有统计学意义(P<0.05)。两组患者术前、术后1 d、术后5 d肝功能水平以及胆管损伤、胆总管结石发生率比较,差异均无统计学意义(P>0.05)。结论对于胆囊结石患者采取Qiaotech硬质胆道镜保胆取石手术治疗,可有效缩短患者住院时间,降低患者术后疼痛,减少术后并发症,具有较大的临床应用潜力。
Objective To explore the effect comparison of Qiaotech rigid biliary tract mirror on gallstone extraction surgery and cholecystectomy in the treatment of gallstones and polyps.Methods A total of 103 patients with gallstones and polyps admitted to Suqian Hospital of Traditional Chinese Medicine from February 2020 to February 2021 were prospectively selected and divided into control group(n=51)and observation group(n=52)by random envelope method.The control group underwent Qiaotech rigid biliary mirror gallbladder graft(polyp)surgery,and the observation group performed conventional cholecystectomy.The efficacy,postoperative pain degree,postoperative serum inflammatory[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)]levels,liver function index[aspartate aminotransferase(AST),alanine aminotransferase(ALT),alkaline phosphatase(ALP),total bilirubin,total protein]and postoperative complications were compared between the two groups of patients.Results The hospitalization time of patients in the observation group was(4.52±1.92)d,significantly shorter than that in the control group[(9.31±1.11)days],the intraoperative bleeding volume,incision length,operation time were(25.41±4.94)mL,(2.71±0.94)cm,(44.81±6.81)h,which were significantly lower than those in the control group[(48.21±5.23)mL,(5.31±1.11)cm,(57.91±5.21)h],and the differences were statistically significant(P<0.05).The VAS scores of the observation group at 6,24 and 48 h were lower than those of the control group,and the differences were statistically significant(P<0.05).Three days after operation,the levels of serum TNF,IL-6 and CRP in the two groups were higher than those before operation,and the levels of TNF,IL-6 and CRP in the observation group were(40.71±6.53)ng/L,(33.21±10.12)pg/L,(12.42±3.44)mg/L,which were lower than those in the control group[(68.15±10.92)ng/L,(55.14±12.42)pg/L,(24.65±7.77)mg/L],and the differences were statistically significant(P<0.05).The incidence of bile reflux gastritis and abdominal distensi
作者
刘斌
柏磊
孙更新
官翠芬
LIU Bin;BAI Lei;SUN Geng-xin(Department of General Surgery,Suqian Hospital of Traditional Chinese Medicine,Suqian Jiangsu 223800,China)
出处
《临床和实验医学杂志》
2023年第6期620-624,共5页
Journal of Clinical and Experimental Medicine
基金
江苏省卫建委科技研究计划(编号:2020S0001528)。
