三步法括约肌切开取石术联合腹腔镜胆囊切除术治疗胆囊结石伴轻中度胰腺炎患者的效果  

Effects of three-step sphincterotomy combined with laparoscopic cholecystectomy in treatment of patients with cholecystolithiasis and mild to moderate pancreatitis

作　　者：车政达 CHE Zhengda(Emergency Department of Haicheng Central Hospital,Haicheng 114200 Liaoning,China)

机构地区：[1]海城市中心医院急诊科,辽宁海城114200

出　　处：《中国民康医学》2022年第9期45-47,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:观察三步法括约肌切开取石术(EST)联合腹腔镜胆囊切除术(LC)治疗胆囊结石伴轻中度胰腺炎患者的效果。方法:选取88例胆囊结石伴轻中度胰腺炎患者为研究对象,按照随机数字表法分为对照组与观察组各44例,对照组行LC治疗,观察组行三步法EST联合LC治疗,比较两组手术相关指标(手术时间、术中出血量、术后进食时间、术后首次活动时间)水平,术后1、7 d相关酶指标[血淀粉酶、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)]水平,并发症发生率,以及胰腺炎复发率。结果:观察组手术时间、术后首次进食时间、术后首次活动时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后7 d,两组血淀粉酶、ALT、AST、ALP水平均低于术后1 d,且观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为2.27%,低于对照组的6.82%,差异有统计学意义(P<0.05);观察组胰腺炎复发率为2.27%(1/44),与对照组的4.55%(2/44)比较,差异无统计学意义(χ^(2)=0.000,P=1.000)。结论:三步法EST联合LC术治疗胆囊结石伴轻中度胰腺炎患者可改善临床相关指标水平,降低酶指标水平和并发症发生率,优于单纯LC治疗效果。Objective:To observe effects of three-step sphincterotomy(EST)combined with laparoscopic cholecystectomy(LC)in treatment of patients with cholecystolithiasis and mild to moderate pancreatitis.Methods:88 patients with cholecystolithiasis and mild to moderate pancreatitis were selected as the research objects and were divided into control group and observation group according to the random number table method,44 cases in each group.The control group received LC treatment,while the observation group was given three-step EST combined with LC treatment.The levels of operation-related indexes(operation time,intraoperative blood loss,postoperative feeding time,postoperative first activity time),the related enzyme index levels[blood amylase,alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP)],the incidence of complications and the pancreatitis recurrence rate were compared between the two groups.Results:The operation time,the postoperative feeding time and postoperative first activity time in the observation group were shorter than those in the control group,the intraoperative blood loss was less than that in the control group,and the differences were statistically significant(P<0.05).On the 7th day after the surgery,the levels of blood amylase,ALT,AST and ALP in the two groups were lower than those on the 1st day after the surgery;those of the observation group were lower than those of the control group;and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 2.27%,which was lower than 6.82% in the control group,and the difference was statistically significant(P<0.05).Further,the pancreatitis recurrence rate in the observation group was 2.27%(1/44),compared with 4.55%(2/44)in the control group,the difference wasn’t statistically significant(χ^(2)=0.000,P=1.000).Conclusions:Three-step EST combined with LC in the treatment of the patients with cholecystolithiasis and mild to moderate pancreatitis can improve the levels of

关 键 词：胆囊结石 轻中度胰腺炎 三步法括约肌切开取石术 酶指标 腹腔镜胆囊切除术 并发症 复发率 

分 类 号：R364.25[医药卫生—病理学] R657.51[医药卫生—基础医学]