腹腔镜胆囊切除术治疗胆囊结石伴慢性胆囊炎患者治疗效果分析  

Efficacyof laparoscopic cholecystectomy in the treatment of patients with gallstones and chronic cholecystitis

作　　者：罗登 赖习华 刘首记[1] Luo Deng;Lai Xihua;Liu Shouji(Department of General Surgery,First Affiliated Hospital,Hunan TCM College,Zhuzhou 412008,Hunan Province,China)

机构地区：[1]湖南中医药高等专科学校附属第一医院普外科,湖南省株洲市412008 [2]中南大学湘雅医学院附属株洲医院普外科

出　　处：《实用肝脏病杂志》2021年第2期276-279,共4页Journal of Practical Hepatology

摘　　要：目的探讨采用腹腔镜胆囊切除术(LC)治疗胆囊结石伴慢性胆囊炎患者的治疗效果及血清胃泌素(GAS)、胃动素(MOT)和血管活性肠肽(VIP)水平的变化。方法2018年3月~2020年3月我院普外科就诊的70例胆囊结石伴慢性胆囊炎患者,采用随机数字表法将患者分为对照组35例和观察组35例,分别行小切口胆囊切除术或行LC术治疗。采用ELISA法检测血清肿瘤坏死因子-ɑ(TNF-ɑ)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)、GAS、MOT和VIP水平。结果观察组手术持续时间为(60.6±6.5)min,显著短于对照组【(95.4±7.2)min,P<0.05】,术后住院日为(5.3±1.4)d,显著短于对照组【(7.7±2.5)d,P<0.05】,术中出血量为(42.3±12.4)mL,显著少于对照组【(124.5±21.7)mL,P<0.05】;术后3 d,观察组血清谷氨酰转肽酶(GGT)水平为(41.4±9.3)U/L,显著低于对照组【(65.1±10.5)U/L,P<0.05】,血清天冬氨酸氨基转移酶(AST)水平为(45.3±17.5)U/L,显著低于对照组【(71.2±19.7)U/L,P<0.05】,血清丙氨酸氨基转移酶(ALT)水平为(28.0±20.5)U/L,显著低于对照组【(59.5±22.8)U/L,P<0.05】;血清CRP水平为(28.4±8.3)ng/L,显著低于对照组【(35.7±8.7)ng/L,P<0.05】,血清IL-6水平为(42.4±5.3)ng/L,显著低于对照组【(47.7±6.7)ng/L,P<0.05】,血清TNF-ɑ水平为(1.9±0.5)μg/L,显著低于对照组【(4.7±0.9)μg/L,P<0.05】;血清GAS水平为(129.5±12.4)ng/L,显著高于对照组【(112.7±10.6)ng/L,P<0.05】,血清MOT水平为(242.4±38.7)ng/L,显著高于对照组【(197.6±42.4)ng/L,P<0.05】,和血清VIP水平为(18.2±3.7)pg/mL,显著低于对照组【(22.8±5.3)pg/mL,P<0.05】;术后,观察组并发症发生率为8.6%,显著低于对照组(20.0%,P<0.05)。结论采用LC治疗胆囊结石伴慢性胆囊炎患者可明显改善手术相关指标,降低血清VIP水平,升高血清GAS和MOT水平,改善胃肠功能,手术安全,疗效肯定。Objective To investigate the efficacy of laparoscopic cholecystectomy(LC)in the treatment of patients with gallstones and chronic cholecystitis.Methods 70 patients with gallstones and chronic cholecystitis were enrolled in our hospital between March 2018 and March 2020,and were randomly divided into control group(n=35)and observation group(n=35).The patients in the control group were treated with open cholecystectomy with small incision,and those in the observation group were treated with LC.Serum gastrin(GAS),vactive intestinal peptide(VIP)and motilin(MOT)levels were detected by ELISA.Results The operationtime in the observation group was(60.6±6.5)min,which was significantly shorter than that in the control group[(95.4±7.2)min,P<0.05],the postoperative hospital stay was(5.3±1.4)d,which was significantly shorter than that in the control group[(7.7±2.5)d,P<0.05],and the intraoperative blood loss was(42.3±12.4)mL,which was significantly less than that in the control group[(124.5±21.7)mL,P<0.05];serum glutamyl transferase(GGT)level in the observation group was(41.4±9.3)U/L,which was significantly lower than in the control group[(65.1±10.5)U/L,P<0.05],serum aspartate aminotransferase(AST)level was(45.3±17.5)U/L,which was significantly lower than in the control group[(71.2±19.7)U/L,P<0.05],and serum alanine aminotransferase(ALT)level was(28.0±20.5)U/L,which was significantly lower than in the control group[(59.5±22.8)U/L,P<0.05];serum C-reactive protein(CRP)level was(28.4±8.3)ng/L,which was significantly lower than in the control group[(35.7±8.7)ng/L,P<0.05],serum interleukin-6(IL-6)level was(42.4±5.3)ng/L,which was significantly lower than that in the control group[(47.7±6.7)ng/L,P<0.05],serum tumor necrosis factor-ɑ(TNF-ɑ)level was(1.9±0.5)μg/L,which was significantly lower than that in the control group[(4.7±0.9)μg/L,P<0.05];serum GAS level was(129.5±12.4)ng/L,which was significantly higher than that in the control group[(112.7±10.6)ng/L,P<0.05],serum MOT level was(242.4±38.7)ng/L,which was

关 键 词：胆囊结石 慢性胆囊炎 腹腔镜胆囊切除术 疗效 胃泌素 胃动素 血管活性肠肽 

分 类 号：R657.4[医药卫生—外科学]