摘要
目的探讨内镜下逆行胰胆管造影术后不同时间行腹腔镜下胆囊切除术治疗老年胆囊结石伴胆总管结石的效果。方法选取2019年8月至2022年8月收治的120例老年胆囊结石伴胆总管结石患者为研究对象,根据内镜下逆行胰胆管造影术后行腹腔镜下胆囊切除术的时间不同将其分为A组、B组,各60例。A组在内镜下逆行胰胆管造影术后3 d内行腹腔镜下胆囊切除术,B组在术后3 d后行腹腔镜下胆囊切除术。比较两组的手术效果。结果术后,A组的白细胞介素-6(IL-6)、C反应蛋白(CRP)及肿瘤坏死因子-α(TNF-α)水平低于B组(P<0.05)。术后,A组的缓激肽(BK)、P物质(SP)及前列腺素E2(PGE2)水平均低于B组(P<0.05)。A组的术后并发症总发生率低于B组(P<0.05)。结论内镜下逆行胰胆管造影术后3 d内行腹腔镜下胆囊切除术可减轻老年胆囊结石伴胆总管结石患者的炎症反应和疼痛应激反应,降低术后并发症发生率,值得推广。
Objective To investigate the effect of laparoscopic cholecystectomy at different time after endoscopic retrograde cholangiopancreatography in the treatment of elderly patients with cholecystolithiasis and choledocholithiasis.Methods A total of 120 elderly patients with cholecystolithiasis and choledocholithiasis from August 2019 to August 2022 were selected as the research objects.According to the different time of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography,the patients were divided into group A and group B,with 60 cases in each group.The group A underwent laparoscopic cholecystectomy within 3 d after endoscopic retrograde cholangiopancreatography,and the group B underwent laparoscopic cholecystectomy after 3 d of operation.The surgical effects of the two groups were compared.Results After operation,the levels of interleukin-6(IL-6),C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)in the group A were lower than those in the group B(P<0.05).After operation,the levels of bradykinin(BK),substance P(SP)and prostaglandin E2(PGE2)in the group A were lower than those in the group B(P<0.05).The total incidence of postoperative complications in the group A was lower than that in the group B(P<0.05).Conclusion Laparoscopic cholecystectomy within 3 d after endoscopic retrograde cholangiopancreatography can relieve the inflammatory response and pain stress response in elderly patients with cholecystolithiasis and choledocholithiasis,and reduce the incidence of postoperative complications,which is worthy of promotion.
作者
郭元
周永纲
王秦玉
GUO Yuan;ZHOU Yonggang;WANG Qinyu(Xianyang Maternal and Child Health Care Hospital,Xianyang 712046;the First People's Hospital of Xianyang,Xianyang 712000;No.215 Hospital of Shaanxi Nuclear Industry,Xianyang 712000,China)
出处
《临床医学研究与实践》
2024年第18期33-36,共4页
Clinical Research and Practice
基金
陕西省核工业二一五医院2020年院级科研立项项目(No.215KYJJ-202013)。
关键词
内镜下逆行胰胆管造影术
腹腔镜下胆囊切除术
胆囊结石
胆总管结石
endoscopic retrograde cholangiopancreatography
laparoscopic cholecystectomy
cholecysto-lithiasis
choledocholithiasis
