不同入路腹腔镜胆囊切除术治疗胆囊结石伴慢性胆囊炎的疗效对比研究  

Comparative study on the effect of laparoscopic cholecystectomy with different approaches in the treatment of cholecystolithiasis with chronic cholecystitis

作　　者：贾振杰[1] JIA Zhen-jie(Department of Hepatobiliary Surgery,Tianjin Huanghe hospital,Tianjin 300110,China)

机构地区：[1]天津市黄河医院肝胆外科,天津300110

出　　处：《中国处方药》2021年第11期139-141,共3页Journal of China Prescription Drug

摘　　要：目的探究胆囊结石伴慢性胆囊炎患者采用不同入路腹腔镜胆囊切除术治疗的临床疗效。方法选取2016年1月~2020年1月收治的82例胆囊结石伴慢性胆囊炎患者为研究对象,按照随机数表法分为对照组和观察组,每组41例,对照组行经胆囊三角入路腹腔镜胆囊切除术,观察组行经胆囊后三角解剖入路腹腔镜胆囊切除术,对比两组手术指标、治疗前后免疫功能指标、炎症因子指标变化情况及并发症发生情况。结果观察组手术时间、术中出血量、住院时间和肠道功能恢复时间均少于对照组(P<0.05)。与治疗前比较,两组治疗后CD8^(+)、CD4^(+)、CD3^(+)、白介素-10(IL-10)水平均有所降低,但观察组高于对照组(P<0.05);两组治疗后白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平均有所提高,但观察组低于对照组(P<0.05)。观察组并发症发生率为2.44%(1/41),低于对照组的14.63%(6/41)(P<0.05)。结论胆囊结石伴慢性胆囊炎采用经胆囊后三角解剖入路腹腔镜胆囊切除术治疗的效果理想,对机体免疫功能与炎症反应产生的影响较小,且术后并发症发生率低。Objective To explore the clinical efficacy of laparoscopic cholecystectomy in the treatment of cholecystolithiasis with chronic cholecystitis.Methods 82 cases of cholecystolithiasis with chronic cholecystitis in our hospital from January 2016 to January 2020 were selected as the research objects,and they were divided into control group and observation group according to random number table method,with 41 cases in each group.The control group received laparoscopic cholecystectomy through the gallbladder triangle approach,and the observation group underwent laparoscopic cholecystectomy through the posterior triangle anatomical approach of gallbladder.The operation indexes and immune function before and after treatment were compared between the two groups.The changes of functional indexes,inflammatory factors and complications were observed.Results the operation time,intraoperative blood loss,hospitalization time and intestinal function recovery time in the observation group were less than those in the control group(P<0.05).The levels of CD8^(+),CD4^(+),CD3^(+),IL-10(interleukin-10)in the two groups were decreased after the operation,but indexes of the observation group was higher than those of the control group(P<0.05);after treatment,the levels of IL-6 and TNF-αin both groups were increased,but the observation group was lower than the control group(P<0.05).The incidence of complications in the observation group was 2.44%(1/41),which was lower than 14.63%(6/41)of the control group(P<0.05).Conclusion Laparoscopic cholecystectomy via the posterior triangle anatomical approach for cholecystolithiasis with chronic cholecystitis is an ideal method with little influence on immune function and inflammatory reaction,and the incidence of postoperative complications is low.

关 键 词：胆囊结石 慢性胆囊炎 不同入路 腹腔镜胆囊切除术 免疫功能 炎症因子 

分 类 号：R657.4[医药卫生—外科学]