不同Calot三角解剖入路腹腔镜胆囊切除术对胆囊结石伴慢性胆囊炎患者的随机对照研究  

A Randomized Controlled Study of Laparoscopic Cholecystectomy with Different Calot Triangle Anatomical Approaches for Cholecystolithiasis Patients with Chronic Cholecystitis

作　　者：蔡建平 CAI Jianping(Zhangjiagang Guanghe Integrated Traditional Chinese and Western Medicine Hospital,Suzhou,Jiangsu,215633)

机构地区：[1]江苏省苏州市张家港广和中西医结合医院,江苏苏州215633

出　　处：《智慧健康》2023年第17期166-169,174,共5页Smart Healthcare

摘　　要：目的 探讨胆囊结石伴慢性胆囊炎应用腹腔镜胆囊切除术(不同Calot三角解剖入路)治疗对患者的临床效果。方法 研究选取2018年7月-2021年9月江苏省苏州市张家港广和中西医结合医院收治的64例胆囊结石伴慢性胆囊炎患者,依据随机数字表法分为对照组、试验组,每组各32例。对照组采取腹腔镜胆囊切除术(经胆囊三角解剖入路)治疗,试验组采取腹腔镜胆囊切除术(经胆囊后三角解剖入路)治疗,两组均于术后随访3个月。比较两组手术指标,血清细胞因子水平、T淋巴细胞亚群水平(术前及术后3d),生活质量评分(术前及术后3个月)情况。结果 与对照组相比,试验组时间指标(住院、手术、肠功能恢复)均更短,试验组出血量(术中)、VAS评分(术后1d)更低;术后3d与术前血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、C反应蛋白(CRP)水平相比,两组均升高,但与对照组相比试验组更低;与术前相比,术后3d两组患者血清CD4+、CD8+水平均降低,但与对照组相比试验组更高;术后3个月与术前生活质量各项评分,两组均升高,但与对照组相比试验组更高(P<0.05)。结论 胆囊结石伴慢性胆囊炎应用腹腔镜胆囊切除术(经胆囊后三角解剖入路)治疗更有利于缓解患者临床症状,优化手术相关指标,减轻手术对机体造成的炎症损伤及免疫抑制,改善生活质量。Objective To investigate clinical effect of laparoscopic cholecystectomy(different calot triangular anatomy approaches)in treatment of cholecystolithiasis with chronic cholecystitis.Methods The paper chose 64 patients with cholecystolithiasis and chronic cholecystitis admitted to Zhangjiagang Guanghe Hospital of Integrated Traditional and Western Medicine from July 2018 to September 2021 for study,and divided them into control group and experiment group according to random number table.Control group was treated with laparoscopic cholecystectomy(through posterior triangle anatomical approach of gallbladder),while observation group with laparoscopic cholecystectomy(through posterior triangle anatomical approach of gallbladder).Both groups were followed up for 3 months after surgery.Surgical indicators,serum cytokine levels,T lymphocyte subpopulation levels(preoperative and postoperative 3 days)and life quality scores(preoperative and postoperative 3 months)were compared between two groups.Results Time indicators(length of stay,surgery and intestinal function recovery)of experimental group were shorter than control group,while bleeding volume(intraoperative)and VAS scores(1 day after surgery)of experimental group were lower,preoperative serum levels of Interleukin 6(IL-6),Interleukin 8(IL-8)and C-reactive protein(CRP),levels of IL-6,IL-8 and CRP in two groups increased 3 days after surgery,but levels in experiment group were lower than control group.Serum CD4+and CD8+levels in both groups decreased 3 days after surgery,experimental group had higher level than control group.Preoperative life quality scores at 3 months after surgery increased,experimental group had higher scores than control group,(both P<0.05).Conclusion Laparoscopic cholecystectomy(via posterior triangular anatomy of the gallbladder)is beneficial to alleviate clinical symptoms of patients with cholecystolithiasis and chronic cholecystitis,optimize relevant surgical indicators,reduce inflammatory damage and immunosuppression caused by surgery and imp

关 键 词：CALOT三角 腹腔镜胆囊切除术 胆囊结石 慢性胆囊炎 

分 类 号：R657.4[医药卫生—外科学]