腹腔镜联合胆道镜胆总管切开取石术对患者CRP、PCT及VAS评分的影响分析  

Analysis of the Effect of Laparoscopic Combined Choledochoproscopy Cholelithotomy on CRP, PCT and VAS Scores in Patients

作　　者：高元兴[1] GAO Yuan-xing(Department of General Surgery,Section Two,Qiqihar First Hospital,Qiqihar,Heilongjiang Province,161000 China)

机构地区：[1]齐齐哈尔市第一医院普外二科,黑龙江齐齐哈尔161000

出　　处：《中外医疗》2018年第15期70-72,共3页China & Foreign Medical Treatment

摘　　要：目的研究腹腔镜联合胆道镜总管切开取石术对患者CRP(C-反应蛋白)、PCT(降钙素原)以及VAS疼痛评分(视觉模拟疼痛评分)的影响。方法随机选择该院自2014年5月—2017年5月收治的100例肝内外胆管结石的患者作为研究对象,按照入院序号的单双号分为两组,每组50例。其中对照组患者为单号患者,进行传统开腹手术取出胆总管结石,观察组患者为双号患者则进行腹腔镜联合胆道镜胆总管切开取石术,比较两组患者的手术前后的炎性反应指标和VAS评分。结果观察组患者手术时间和术中出血量,以及术后首次的排气时间和术后住院时间均显著少于对照组(P<0.05);观察组术后1、3 d的CRP值分别为(31.25±12.97)、(21.31±8.78)mg/L,PCT值(4.61±1.23)、(2.44±1.31)μg/L显著低于对照组(t=6.531、3.370;t=7.298、7.420,P<0.05);且观察组术后3、12 h的VAS评分为(5.13±1.33)分、(4.01±1.23)分,均显著低于对照组(t=7.312、8.500,P<0.05)。结论腹腔镜联合胆道镜胆总管切开取石术对胆总管结石患者的疗效更好,伤口小,术后炎症反应低,术后疼痛度低,患者预后效果良好,可在临床上广泛推荐应用。Objective This paper tries to study the effect of laparoscopy combined with choledochoscopy on CRP（C-reactive protein）, PCT（procalcitonin） and VAS pain score（visual analogue pain score）. Methods 100 patients with intrahepatic and extrahepatic bile duct stones who were treated in this hospital from May 2014 to May 2017 were random selected as the research objects. They were divided into two groups according to the number of admissions, with 50 cases in each group.The patients in the control group were patients with a single number who underwent conventional laparotomy for removal of common bile duct stones. Patients in the observation group with double number underwent laparoscopic combined bile duct incision and lithotripsy. The inflammatory status, response indicators and VAS scores before and after surgery were compared between the two groups of patients. Results The operative time and intraoperative blood loss in the observation group,as well as the first time after the operation and postoperative hospital stay were significantly less than the control group（P〈0.05）; the CRP values of the observation group on the 1 st and 3 rd days after the operation were（31.25±12.97）,（21.31±8.78）mg/L,PCT values（4.61±1.23）,（2.44±1.31）μg/L were significantly lower than the control group（t=6.531, 3.370; t=7.298, 7.420, P〈0.05）; and observation group of VAS scores at 3 and 12 hours after operation were（5.13±1.33）points and（4.01±1.23）points,which were significantly lower than those of the control group（t=7.312, 8.500, P〈0.05）. Conclusion Laparoscopic choledocholithotomy combined with choledocholithotomy for choledocholithiasis has better efficacy, smaller wounds, lower postoperative inflammatory reaction, lower postoperative pain, and good prognosis. It can be widely recommended in clinical practice.

关 键 词：胆总管结石 腹腔镜 胆道镜 胆总管切开取石术 PCT CRP VAS评分 

分 类 号：R364.25[医药卫生—病理学]