腹腔镜下胆总管探查术治疗胆总管结石的临床效果  

Clinical effect of laparoscopic common bile duct exploration in the treatment of common bile duct stones

作　　者：张鑫[1] 杨刚 李胜[1] 张雄[1] ZHANG Xin;YANG Gang;LI Sheng;ZHANG Xiong(No.2 Ward of General Surgery Department,Yulin No.2 Hospital,Yulin 719000,China)

机构地区：[1]榆林市第二医院普通外科二病区,陕西榆林719000

出　　处：《临床医学研究与实践》2023年第5期47-50,共4页Clinical Research and Practice

摘　　要：目的探讨腹腔镜下胆总管探查术治疗胆总管结石的临床效果。方法选取2018年1月至2021年1月本院收治的200例胆总管结石患者为研究对象,按照随机数字表法将其分为参照组和研究组,各100例。参照组开展开腹手术,研究组开展腹腔镜下胆总管探查术。比较两组的治疗效果。结果研究组的术后肛门排气时间、肠鸣音恢复时间及住院时间短于参照组,差异具有统计学意义(P<0.05)。术后24 h,研究组的皮质醇、去甲肾上腺素、血管紧张素Ⅱ水平低于参照组,差异具有统计学意义(P<0.05)。术后24 h,研究组的胃泌素(GAS)、胃动素(MTL)水平高于参照组,缩胆囊素(CCK)水平低于参照组,差异具有统计学意义(P<0.05)。术后24 h,研究组的内毒素(ET)、二胺氧化酶(DAO)、D-乳酸(DLA)水平低于参照组,差异具有统计学意义(P<0.05)。术后24 h,研究组的C反应蛋白(CRP)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平低于参照组,差异具有统计学意义(P<0.05)。结论腹腔镜下胆总管探查术治疗胆总管结石可缩短康复时间,减轻应激反应及炎症反应,对胃肠功能影响较小,值得应用。Objective To explore the clinical effect of laparoscopic common bile duct exploration in the treatment of common bile duct stones.Methods A total of 200 patients with common bile duct stones admitted in our hospital from January 2018 to January 2021 were selected as the research objects.According to the random number table method,the patients were divided into reference group and study group,with 100 cases in each group.The reference group underwent laparotomy,and the study group underwent laparoscopic common bile duct exploration.The therapeutic effects of the two groups were compared.Results The postoperative anal exhaust time,bowel sound recovery time and hospitalization time of the study group were shorter than those of the reference group,the differences were statistically significant(P<0.05).At 24 h after operation,the levels of cortisol,norepinephrine,angiotensinⅡin the study group were lower than those in the reference group,and the differences were statistically significant(P<0.05).At 24 h after operation,the levels of gastrin(GAS),motilin(MTL)in the study group were higher than those in the reference group,the level of cholecystokinin(CCK)was lower than that in the reference group,and the differences were statistically significant(P<0.05).At 24 h after operation,the levels of endotoxin(ET),diamine oxidase(DAO),D-lactic acid(DLA)in the study group were lower than those in the reference group,and the differences were statistically significant(P<0.05).At 24 h after operation,the levels of C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the study group were lower than those in the reference group,the differences were statistically significant(P<0.05).Conclusion Laparoscopic common bile duct exploration in the treatment of common bile duct stones can shorten the recovery time,reduce stress response and inflammatory response,and has little effect on gastrointestinal function,which is worthy of application.

关 键 词：胆总管结石 腹腔镜下胆总管探查术 应激反应 胃泌素族激素 肠黏膜屏障 

分 类 号：R575.6[医药卫生—消化系统]