非急性期行腹腔镜胆囊切除术对老年患者血清应激指标的影响  

Influence by laparoscopic cholecystectomy in non-acute phase on serum stress index of senile patients

作　　者：王铁[1] 王铁夫 李雪松[1] 赵明明[1] 赵海峰[1] 张喜晶[1] 

机构地区：[1]黑龙江省大庆市人民医院,163316 [2]黑龙江省大庆市医学会

出　　处：《中国实用医药》2017年第12期42-44,共3页China Practical Medicine

摘　　要：目的观察非急性期腹腔镜胆囊切除术对老年患者血清应激指标的影响。方法行腹腔镜胆囊切除术的老年患者35例纳入观察组,同期行开腹式胆囊切除术老年患者30例作为对照组。比较两组患者手术一般指标、血清应激指标。结果观察组手术时间为(89.5±22.8)min,术中出血量为(67.5±20.4)ml,下床时间为(23.3±5.8)h。对照组手术时间为(86.7±24.7)min,术中出血量为(118.9±37.2)ml,下床时间为(30.1±7.6)h。两组手术时间比较差异无统计学意义(P>0.05);观察组术中出血量少于对照组,下床时间早于对照组,差异有统计学意义(P<0.05)。与术前1 d比较,术后1 d两组患者C反应蛋白、空腹血糖及皮质醇水平均有所升高,但观察组低于对照组,差异有统计学意义(P<0.05)。结论腹腔镜胆囊切除术对老年患者血清中应激指标影响较开腹手术小,这可能是腹腔镜胆囊切除术患者术后恢复快的原因之一。Objective To observe influence by laparoscopic cholecystectomy in non-acute phase on serum stress index of senile patients. Methods There were 35 senile patients receiving laparoscopic cholecystectomy as observation group, and 35 senile patients at the same period receiving open cholecystectomy as control group. Comparison was made on general surgical index and serum stress index between the two groups. Results The observation group had operation time as （89,5 ± 22.8） min, intraoperative bleeding volume as （67.5 ± 20.4） ml, and off-bed time as （23.3 ± 5.8） h. The control group had operation time as （86.7 ± 24.7） min, intraoperative bleeding volume as （118.9 ± 37.2） ml, and off-bed time as （30.1 ± 7.6） h. There was no statistically significant difference of operation time between the two groups （P〉0.05）. The observation group had less intraoperative bleeding volume and earlier off-bed time than the control group, and their difference had statistical significance （P〈0.05）. Comparing with those in preoperative 1 d, both groups had higher C-reactive protein, fasting blood glucose and cortisol levels in postoperative 1 d, while those in the observation group were lower than the control group, and their difference had statistical significance （P〈0.05）. Conclusion Laparoscopiccholecystectomy shows less impact on serum stress index in senile patients than open surgery, which acts as one of the reasons for quick postoperative rehabilitation by laparoscopic cholecystectomy.

关 键 词：腹腔镜 胆囊切除术 开腹式 血清应激指标 非急性期 老年患者 

分 类 号：R657.4[医药卫生—外科学]