腹腔镜解剖性肝左外叶切除术对肝内胆管结石患者围手术期指标和血清因子与生命质量及并发症的影响  

Effect of laparoscopic anatomical hepatic left outer lobectomy on perioperative indicators and serum factors,quality of life and complications in patients with intrahepatic bile duct stones

作　　者：方宁波[1] FANG Ningbo(Department of Hepatobiliary and Pancreatic Surgery,Jiujiang NO.1 People's Hospital,Jiujiang,Jiangxi,332000,China)

机构地区：[1]九江市第一人民医院肝胆胰外科,江西九江332000

出　　处：《当代医学》2023年第4期43-46,共4页Contemporary Medicine

摘　　要：目的探讨腹腔镜解剖性肝左外叶切除术对左肝内胆管结石患者围手术期指标、血清因子、生命质量及并发症的影响。方法选取2018年5月至2021年5月本院收治的80例左肝内胆管结石患者作为研究对象,采用随机数字表法分为观察组与对照组,每组40例。对照组行开腹解剖性肝左外叶切除术,观察组行腹腔镜解剖性肝左外叶切除术,比较两组手术指标、术后恢复指标、手术前后血清因子水平、生命质量及并发症发生情况。结果观察组手术时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。术后下床时间、饮食恢复时间、术后排气时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。术后,观察组活力、躯体功能、生理职能、一般健康、社会功能、精神健康、情绪角色评分均高于对照组,差异有统计学意义(P<0.05)。术后,观察组皮质醇(Cor)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、肾上腺素(E)水平均低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为5.0%,明显低于对照组的22.5%,差异有统计学意义(P<0.05)。结论腹腔镜解剖性肝左外叶切除术治疗左肝内胆管结石患者效果显著,能明显改善患者围手术期指标及血清因子水平,促进患者康复,还可减少并发症的发生,提高生命质量。Objective To investigate the effect of laparoscopic anatomical hepatic left outer lobectomy on perioperative indicators,serum fac-tors,quality of life and complications in patients with intrahepatic bile duct stones.Methods 80 patients with left intrahepatic bile duct stones admit-ted to our hospital from May 2018 to May 2021 were selected as the study subjects,and they were divided into the observation and the control groups according to the random number table method,with 40 cases in each group.The control group underwent open anatomical hepatic left outer lobecto-my,and the observation group underwent laparoscopic anatomical hepatic left outer lobectomy,the surgical indexes,postoperative recovery indexes,serum factors level before and after surgery,quality of life and complications were compared between the two groups.Results The operation time in the observation group was shorter than that in the control group,and the intraoperative bleeding was less than that in the control group,and the differ-ence was statistically significant(P<0.05).The postoperative bed time,dietary recovery time,postoperative exhaustion time and hospitalization time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).After surgery,the vigor,somatic function,physical function,general health,social function,mental health,and emotional role scores in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After surgery,the levels of cortisol(Cor),interleu-kin-6(IL-6),C-reactive protein(CRP)and epinephrine(E)in the observation group were lower than those in the control group,and the differences werestatistically significant(P<0.05).The incidence of complication in the observation group was 5.0%,which was significantly lower than 22.5%in the control group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic anatomical hepatic left outer lobectomy has significant effects

关 键 词：腹腔镜 开腹式 解剖性肝左外叶切除术 左肝内胆管结石 血清因子 并发症 生命质量 

分 类 号：R657.4[医药卫生—外科学]