摘要
目的探讨腹腔镜辅助下胆总管探查术后一期缝合治疗肝外胆总管结石的效果。方法选取2020年1月至2023年1月我院收治的80例肝外胆总管结石患者为研究对象,随机将其分为对照组(40例,腹腔镜辅助下胆总管探查术后T管引流)和观察组(40例,腹腔镜辅助下胆总管探查术后一期缝合)。比较两组的手术效果。结果观察组的手术时间、腹腔引流时间及住院时间短于对照组,术后输液量少于对照组(P<0.05)。观察组的腹痛缓解时间、肠鸣音消失时间及肛门排气恢复时间短于对照组(P<0.05)。术后,观察组的C-反应蛋白(CRP)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平低于对照组(P<0.05)。术后,观察组的血管紧张素Ⅰ(AngⅠ)、血管紧张素Ⅱ(AngⅡ)及血管紧张素(1-7)[Ang-(1-7)]水平低于对照组(P<0.05)。观察组的并发症总发生率低于对照组(P<0.05)。结论腹腔镜辅助下胆总管探查术后一期缝合治疗肝外胆总管结石可缩短手术时间,降低术后输液量,加快术后康复速度,促进胃肠功能恢复,调节炎性因子水平,也能减轻机体应激程度,降低并发症发生率,值得推广。
Objective To investigate the effect of primary suture after laparoscopic-assisted common bile duct exploration in the treatment of extrahepatic common bile duct stones.Methods A total of 80 patients with extrahepatic common bile duct stones admitted in our hospital from January 2020 to January 2023 were selected as the study objects and randomly divided into control group(40 cases,T-tube drainage after laparoscopic-assisted common bile duct exploration)and observation group(40 cases,primary suture after laparoscopic-assisted common bile duct exploration).The surgical effects of the two groups were compared.Results The operation time,abdominal drainage time and hospitalization time of the observation group were shorter than those of the control group,and the postoperative infusion volume was less than that of the control group(P<0.05).The relief time of abdominal pain,disappearance time of bowel sounds and recovery time of anal exhaust in the observation group were shorter than those in the control group(P<0.05).After operation,the levels of C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the observation group were lower than those in the control group(P<0.05).After operation,the levels of angiotensinⅠ(AngⅠ),angiotensinⅡ(AngⅡ)and angiotensin-(1-7)[Ang-(1-7)]in the observation group were lower than those in the control group(P<0.05).The total incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion Primary suture after laparoscopic-assisted common bile duct exploration for extrahepatic common bile duct stones can shorten the operation time,reduce the amount of postoperative infusion,accelerate the speed of postoperative recovery,promote the recovery of gastrointestinal function,regulate the levels of inflammatory factors,and also relieve the degree of stress and reduce the incidence of complications,which is worth promoting.
作者
马长峰
简国文
MA Changfeng;JIAN Guowen(People's Hospital of Xi'an Yanliang District,Xi'an 710089,China)
出处
《临床医学研究与实践》
2024年第32期75-78,共4页
Clinical Research and Practice
关键词
腹腔镜
胆总管探查术
一期缝合
肝外胆总管结石
胃肠功能
炎性因子
laparoscope
common bile duct exploration
primary suture
extrahepatic common bile duct stone
gastrointestinal function
inflammatory factor
