侧方入路剥离胆囊腹腔镜胆囊切除术治疗胆囊良性疾病患者的近期随访研究  

A Recent Follow-Up Study of Patients with Benign Gallbladder Disease Treated by Laparoscopic Cholecystectomy with Lateral Approach

作　　者：王效鸿 WANG Xiaohong(Department of General Surgery,Ningling People’s Hospital,Shangqiu 476700,China)

机构地区：[1]宁陵县人民医院普外科,河南商丘476700

出　　处：《河南医学研究》2021年第26期4894-4896,共3页Henan Medical Research

摘　　要：目的探究腹腔镜胆囊切除术(LC)侧方入路剥离胆囊对胆囊良性疾病的治疗效果。方法选取2018年4月至2020年5月宁陵县人民医院收治的146例胆囊良性疾病患者作为研究对象,观察组77例剥离胆囊行侧方入路,对照组69例剥离胆囊行顺行或逆行。统计对比两组手术相关指标、手术前后应激激素[去甲肾上腺素(NE)、皮质醇(Cor)]水平,采用视觉模拟评分(VAS)评估患者术后疼痛程度,采用消化病生存质量指数(GLQI)评估患者生活质量。结果两组术中出血量及手术时间比较,差异无统计学意义(P>0.05);观察组胆囊剥离时间、术后引流置管时间短于对照组,术后引流量、术后并发症发生率较对照组低(P<0.05);观察组术后12 h VAS评分、血清Cor、NE水平低于对照组(P<0.05);术后3、6周,两组GLQI评分相比,差异无统计学意义(P>0.05)。结论侧方入路剥离胆囊LC具有入路合理、操作可控性强、手术术野清晰等优势,有助于缩短胆囊剥离时间、减少手术并发症,且创伤应激较小,患者生活质量高。Objective To investigate the therapeutic effect of laparoscopic cholecystectomy(LC)with lateral approach for gallbladder dissection in benign gallbladder diseases.Methods A total of 146 patients with benign gallbladder disease in Ningling People’s Hospital from April 2018 to May 2020 were selected as the research objects.Seventy-seven patients in the observation group underwent lateral approach for gallbladder dissection,and 69 patients in the control group underwent anterograde or retrograde treatment for gallbladder dissection.Surgation-related indexes,levels of stress hormones[norepinephrine(NE)and cortisol(Cor)]before and after surgery were statistically compared between the two groups.The visual simulation score(VAS)was used to assess the postoperative pain.Gastro-intestinal quality of life index(GLQI)was used to assess the quality of life.Results There was no significant difference in the amount of intraoperative blood loss and operation time between the two groups(P>0.05).The time of gallbladder dissection,time of postoperative drainage tube placement in observation group were shorter than those in control group,and postoperative drainage volume in observation group were lower than those in control group,the incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).The VAS at 12 h after surgery in the observation group were lower than those in the control group,the serum levels of Cor and NE in observation group 12 h after operation were lower than those in control group(P<0.05).There was no significant difference in GLQI scores between the two groups 3 and 6 weeks after surgery(P>0.05).Conclusion Lateral approach to gallbladder dissection laparoscopic cholecystectomy has the advantages of reasonable approach,strong operation control and clear surgical field,which is helpful to shorten the time of gallbladder dissection and reduce surgical complications,and less traumatic stress,which is helpful to improve the quality of life of patients.It is wort

关 键 词：胆囊良性疾病 侧方入路剥离胆囊 腹腔镜胆囊切除术 

分 类 号：R575.6[医药卫生—消化系统]