微创保胆取石术对小儿胆囊结石的临床效果及血清炎性因子水平的影响  

Clinical effect of minimally invasive gallblade⁃preserving cholelithotomy for children with cholecystolithiasis and its influence on serum inflammatory factors

作　　者：张强[1] 侯丹杰 张爱辉[1] 张生[3] ZHANG Qiang;HOU Danjie;ZHANG Aihui;ZHANG Sheng(Thoracic Surgery Department,Xi’an Children’s Hospital,Xi’an,Shaanxi 710003,China;Section 1 of Urology Surgery Department,Xi’an Children’s Hospital,Xi’an,Shaanxi 710003,China;Section 1 of General Surgery Department,Xi’an Children’s Hospital,Xi’an,Shaanxi 710003,China)

机构地区：[1]西安市儿童医院胸外科,陕西西安710003 [2]西安市儿童医院泌尿外科一病区,陕西西安710003 [3]西安市儿童医院普外科一病区,陕西西安710003

出　　处：《安徽医药》2020年第12期2474-2477,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨在胆囊结石病儿中应用微创保胆取石术的疗效及其对病儿血清炎性因子水平的影响。方法回顾性分析2010年1月至2019年5月共计62例西安市儿童医院收治的胆囊结石病儿的临床资料,将32例行腹腔镜胆囊切除术的病儿纳入对照组,将30例行微创保胆取石术的病儿纳入观察组。比较两组病儿手术时间、术中出血量、肛门排气时间及住院时间;比较两组病儿手术前、术后1 d及术后3 d血清白细胞介素⁃6(IL⁃6)、白细胞介素⁃8(IL⁃8)、超敏C反应蛋白(hs⁃CRP)及肿瘤坏死因子α(TNF⁃α)水平;比较两组病儿术后并发症发生情况。结果两组病儿手术时间相比较差异无统计学意义(P>0.05),观察组病儿术中出血量、肛门排气时间及住院时间均少于对照组病儿[(19.03±6.23)mL比(40.97±8.94)mL;(19.63±5.56)h比(23.06±6.03)h;(4.50±1.20)d比(6.25±1.61)d](P<0.05);术后1 d及术后3 d,观察组病儿血清IL⁃6、IL⁃8、hs⁃CRP及TNF⁃α水平均低于对照组病儿及手术前(P<0.05);观察组病儿并发症总发生率(6.7%)低于对照组病儿(28.1%)(P<0.05)。结论微创保胆取石术治疗小儿胆囊结石能够减少炎性因子的表达且创伤小,可有效改善临床症状且术后并发症相对较低。Objective To explore the effect of minimally invasive gallblade⁃preserving cholelithotomy in children with cholecystoli⁃thiasis and its influence on serum inflammatory factors.Methods The clinical data of 62 children with cholecystolithiasis who were admitted to Xi’an Children’s Hospital from January 2010 to May 2019 were retrospectively analyzed.32 children who under⁃went laparoscopic cholecystectomy were included in the control group,and 30 children who underwent minimally invasive gallblade⁃preserving cholelithotomy were included in the observation group.The operation time,intraoperative blood loss,anal exhaust time and hospitalization time were compared between the two groups.The serum levels of IL⁃6,IL⁃8,hs⁃CRP and TNF⁃αin the two groups were compared before surgery,1 day after surgery and 3 days after surgery.Postoperative complications were compared be⁃tween the two groups.Results There was no difference in operative time between the two groups(P>0.05),and the intraoperative blood loss,anal exhaust time and hospital stay time in the observation group were all less than those in the control group[(19.03±6.23)mL vs.(40.97±8.94)mL;(19.63±5.56)h vs.(23.06±6.03)h;(4.50±1.20)d vs.(6.25±1.61)d](P<0.05).Both 1 day and 3 days after surgery,the serum levels of IL⁃6,IL⁃8,hs⁃CRP and TNF⁃αin the observation group were lower than those in the con⁃trol group and before surgery(P<0.05).The total incidence of complications in the observation group(6.7%)was lower than 28.1%of the control group(P<0.05).Conclusion The minimally invasive gallblade⁃preserving cholelithotomy used for the treat⁃ment in children with cholecystolithiasis can reduce the expression of inflammatory factors,have little trauma,improve clinical symptoms effectively and have low postoperative complications.

关 键 词：胆囊结石病 最小侵入性外科手术 胆囊切除术 腹腔镜 儿童 保胆取石术 

分 类 号：R726.5[医药卫生—儿科]