不同手术时机运用腹腔镜治疗胆囊结石所致急性胰腺炎的效果及安全性研究  

Study on the Efficacy and Safety of Laparoscopy in the Treatment of Acute Pancreatitis Caused by Gallbladder Stones at Different Operation Times

作　　者：朱海丰[1] ZHU Haifeng(Department of General Surgery,Nantong Hospital of Traditional Chinese Medicine,Nantong,Jiangsu Province,226001 China)

机构地区：[1]南通市中医院普外科,江苏南通226001

出　　处：《中外医疗》2022年第3期80-83,112,共5页China & Foreign Medical Treatment

摘　　要：目的探讨不同手术时机腹腔镜手术在胆囊结石所致急性胰腺炎中的治疗效果。方法该研究选取2016年1月—2020年12月该院收治的80例胆囊结石所致急性轻型胰腺炎患者,按照奇偶数法分组,对照组为奇数者(1、3、5等),观察组为偶数者(2、4、6等),每组40例,均行腹腔镜胆囊切除术,对照组行延期手术,于病情稳定后8~12周进行,观察组采取早期手术,发病1周内实施,对比两组手术指标、恢复情况,手术前后血清指标,胃肠功能恢复情况及并发症和预后情况。结果观察组手术时间、出血量、下床活动时间、引流时间、并发症发生率、中转开腹率与对照组比较,差异无统计学意义(P>0.05);观察组肠道蠕动时间、肛门排气时间、排便时间、首次进食时间分别为(11.18±1.72)、(13.45±1.64)、(17.12±1.42)、(20.21±1.56)h,短于对照组的(14.32±2.16)、(17.27±1.32)、(20.56±1.18)、(24.27±2.15)h,组间对比差异有统计学意义(t=7.129、11.476、11.784、9.667,P<0.05);两组手术治疗前后血清指标组间对比差异无统计学意义(P>0.05),对照组和观察组术后血清淀粉酶、碱性磷酸酶、天门冬氨酸氨基转移酶、丙氨酸氨基转移酶和总胆红素与各组术前对比,差异有统计学意义(P<0.05)。结论早期与择期手术效果和预后情况对比一致,对患者肝功能损害不明显;与择期手术对比,早期腹腔镜下胆囊切除术治疗胆囊结石所致急性胰腺炎效果明显,可促进胃肠功能恢复,也可缩短住院时间,更具推广价值。Objective To explore the therapeutic effect of laparoscopic surgery on acute pancreatitis caused by gallbladder stones at different surgical times.Methods This study selected 80 patients with acute mild pancreatitis caused by gallbladder stones who were treated in the hospital from January 2016 to December 2020.Grouped according to the odd-even method,the control group was odd-numbered(1,3,5,etc.),and the observation group was even-numbered(2,4,6,etc.),with 40 cases in each group.All patients underwent laparoscopic cholecystectomy,the control group underwent delayed surgery,8-12 weeks after the disease was stable,and the observation group underwent early surgery,which was performed within 1 week of onset.The surgical indicators,recovery status,serum indicators and recovery of gastrointestinal function before and after surgery,and complications and prognosis were compared between the two groups.Results There were no statistically significant differences in the operation time,blood loss,time to get out of bed,drainage time,complication rate,and conversion to laparotomy between the observation group and the control group(P>0.05).In the observation group,intestinal peristalsis time,anal exhaust time,defecation time,and first meal time were(11.18±1.72)h,(13.45±1.64)h,(17.12±1.42)h and(20.21±1.56)h,respectively,shorter than the control group(14.32±2.16)h,(17.27±1.32)h,(20.56±1.18)h and(24.27±2.15)h,the difference between groups was statistically significant(t=7.129,11.476,11.784,9.667,P<0.05).There was no statistically significant difference in the comparison of serum indexes between the two groups before and after surgery(P>0.05),the postoperative serum amylase,alkaline phosphatase,aspartate aminotransferase,alanine aminotransferase and total bilirubin of the control group and the observation group were compared with those of each group before operation,the difference was statistically significant(P<0.05).Conclusion The effect and prognosis of early and selective surgery are consistent,and the liver function d

关 键 词：腹腔镜手术 手术时机 胆囊结石 急性胰腺炎 血清指标 胃肠功能 

分 类 号：R657.4[医药卫生—外科学] R576[医药卫生—临床医学]