不同胆囊床止血方式在腹腔镜胆囊切除术中的应用  

Application of different hemostatic ways in gallbladder bed bleeding during laparoscopic cholecystectomy

作　　者：蔡伟[1] 曹勇[1] 胡建平[1] 黄林义[1] 

机构地区：[1]南京医科大学附属江宁医院普外二科,江苏南京211100

出　　处：《现代医学》2014年第11期1339-1342,共4页Modern Medical Journal

摘　　要：目的:观察腹腔镜胆囊切除术(LC)中不同的胆囊床止血方式对机体的影响,探讨LC中使用电凝钩行胆囊床止血的可行性。方法:对在我院行LC术的50例患者随机使用电凝钩和电凝棒进行胆囊床止血,各25例,分别于术前及术后24、72 h抽取肘静脉血检测肝功能、血浆C-反应蛋白(CRP)及白细胞介素-6(IL-6)等指标进行比较研究,同时比较两组患者手术时间、术后肠功能恢复时间、术后住院天数等指标。结果:两组患者手术时间、手术后肠功能恢复时间及术后住院天数比较,差异均无统计学意义(P>0.05);两组患者术前及术后24、72 h肝功能、CRP、IL-6等指标比较,差异均无统计学意义(P>0.05)。结论:LC中使用电凝钩或电凝棒行胆囊床止血对机体影响程度相似,电凝钩胆囊床止血操作方便,安全可行。Objective： To observe the effect of different hemostatic ways in gallbladder bed bleeding during LC on body and explore the feasibility of using electric coagulation hook during laparoscopic cholecystectomy （LC）. Methods： Fifty patients operated with LC in our hospital were randomly divided into 2 groups, 25 patients in each group, the electric coagulation hook or electric coagulation rod in gallbladder bed were used respectively. Venous blood at preoperative, postoperative 24 h, 72 h were extracted respectively to test indicators such as liver function, C- reactive protein（CRP） and interleukin- 6 （ IL- 6 ）, and each indicators were comparatively studied. Operation time, postoperative intestinal function recovery time, postoperative hospitalization days were compared between the two groups. Results： Operation time, postoperative intestinal function recovery time, postoperative hospitalization days between the two groups had no statistically significant difference（P 〉 0. 05 ）, and liver function, CRP, IL-6 of two groups which were extracted at preoperative, postoperative 24 h, 72 h were no significantly difference （ P 〉 0. 05 ） between the two groups. Conclusion：There is similar effect on the body whatever electric coagulation hook or electric coagulation rods used in gallbladder bed bleeding during EC,but electric coagulation hook is easy to operate, safe and feasible.

关 键 词：腹腔镜胆囊切除术 肝功能 C-反应蛋白 白细胞介素-6 电凝钩 

分 类 号：R657[医药卫生—外科学]