腹腔镜胆囊切除术联合生长抑素在急性胆囊炎患者中的应用研究  

Study on the application of laparoscopic cholecystectomy combined with somatostatin in patients with acute cholecystitis

作　　者：张立献[1] 王国珍 韩雪[1] 蒋光林 ZHANG Li-xian;WANG Guo-zhen;HAN Xue(Department of General Surgery,North China Petroleum Administration General Hospital,Renqiu Hebei 062552,China;Department of Hemodialysis Room,Kangji Xintu Hospital of Renqiu,Renqiu Hebei 062552,China)

机构地区：[1]华北石油管理局总医院普外科,河北任丘062552 [2]河北省任丘市康济新图医院血透室,河北任丘062552

出　　处：《临床和实验医学杂志》2018年第6期640-644,共5页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨腹腔镜胆囊切除术联合生长抑素对急性胆囊炎患者术后血清脂肪酶(LPS)、前白蛋白(PA)、抵抗素(resistin)水平及生活质量的影响。方法选取2015年12月至2017年7月急性胆囊炎患者84例临床资料进行回顾性分析,根据治疗方案分为对照组(n=42)与研究组(n=42)。常规干预基础上研究组采取生长抑素+腹腔镜胆囊切除术,对照组仅采取腹腔镜胆囊切除术。统计两组术后肛门初次排气时间、肛门初次排便时间及住院时间、治疗前及治疗后第3天肝功能指标[总胆红素(TBIL)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)]水平、血清炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平及血清LPS、PA、抵抗素水平、生活质量(SF-36)评分。结果研究组肛门初次排气时间、肛门初次排便时间及住院时间较对照组短(P<0.05);术后第3天两组血清TBIL、AST及ALT水平较治疗前增高,但研究组各指标水平较对照组低(P<0.05);术后第3天两组血清IL-6、TNF-α水平较治疗前降低,且研究组较对照组低(P<0.05);治疗后两组血清LPS、抵抗素水平较治疗前降低,PA水平较治疗前增高,且研究组血清LPS、抵抗素水平较对照组低,PA水平较对照组高(P<0.05);治疗后1个月两组SF-36分值较治疗前增高,且研究组较对照组高(P<0.05)。结论腹腔镜胆囊切除术基础上采取生长抑素治疗急性胆囊炎,可缩短患者机体功能康复及住院时间,减轻对肝功能的损害,降低LPS、抵抗素等水平,缓解炎症反应,改善营养状态,提高患者生活质量。Objective To investigate the effect of laparoscopic cholecystectomy combined with somatostatin on serum lipase(LPS),prealbumin(PA)and resistin levels and quality of life in patients with acute cholecystitis after operation.Methods The clinical data of 84 cases of acute cholecystitis in our hospital from December 2015 to July 2017 were retrospectively analyzed and randomly divided into the control group(n=42)and the study group(n=42).On the basis of routine intervention,the study group was treated with somatostatin+laparoscopic cholecystectomy,while the control group was only treated with laparoscopic cholecystectomy.The first anal exhaust time,anal initial defecation time and hospitalization time,liver function indexes[total bilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT)]before and after 3 d of treatment,serum inflammatory factors[interleukin-6(IL-6),tumor necrosis factor alpha(TNF-alpha)]levels,serum LPS,PA and resistin levels and quality of life(SF-36)score were counted in the two groups.Results The initial anal exhaust time,anal initial defecation time and hospitalization time of the study group were less than those of the control group(P<0.05).At the 3rd d after treatment,serum TBIL,AST and ALT levels in the two groups increased compared with before treatment,but the indexes in the study group were lower than those in the control group(P<0.05).At the 3rd d after treatment,serum IL-6 and TNF-αlevels of the two groups were lower than those before treatment,and the study group was lower than the control group(P<0.05).After treatment,the serum LPS and resistin levels of the two groups were lower than those before treatment,the level of PA was higher than that before treatment,and the level of serum LPS and resistin in the study group was lower than that of the control group,and the level of PA was higher than that of the control group(P<0.05).After 1 month of treatment,the SF-36 scores of two groups were higher than those before treatment,and the study group was higher than the con

关 键 词：急性胆囊炎 腹腔镜胆囊切除术 生长抑素 脂肪酶 前白蛋白 抵抗素 生活质量 

分 类 号：R657.41[医药卫生—外科学]