腹腔镜下行胆囊切除术治疗胆囊息肉样病变的临床效果及应激反应分析  

Analysis of Clinical Effect and Stress Reaction of Laparoscopic Cholecystectomy for Polypoid Lesions of Gallbladder

作　　者：丁林峰 连志刚[1] 林峰 DING Linfeng;LIAN Zhigang;LIN Feng(Department of Hepatobiliary,Pancreatic and Hernia Surgery,Sanming First Hospital,Sanming,Fujian Province,365000 China)

机构地区：[1]三明市第一医院肝胆胰疝外科,福建三明365000

出　　处：《中外医疗》2024年第5期90-94,共5页China & Foreign Medical Treatment

摘　　要：目的评估腹腔镜下胆囊切除术(Laparoscopic Cholecystectomy,LC)应用在胆囊息肉样病变(Polypoid Lesions of The Gallbladder,PLG)患者中的临床效果及对应激反应的影响。方法随机选取2019年12月—2022年12月三明市第一医院收治的80例PLG患者为研究对象,参照随机数表法分为对照组[40例,实施开腹胆囊切除术(Open Cholecystectomy,OC)治疗]、观察组(40例,行LC治疗)。评价两组手术相关参数、应激反应、炎症反应以及术后并发症发生率。结果与对照组相比,观察组手术相关参数更佳,差异有统计学意义(P<0.05)。术前,两组应激反应[包括血糖(Blood Glucose,BG)、皮质醇(Cortisol,Cor)、肾上腺素(Epinephrine,E)]、炎症因子[包括C反应蛋白(C-Reactive Protein,CRP)、白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-8(Interleukin-8,IL-8)]比较,差异无统计学意义(P均>0.05);术后1 d,观察组应激反应指标(BG、Cor、E)、炎症因子(CRP、IL-6、IL-8)水平低于对照组,差异有统计学意义(P均<0.05)。观察组术后并发症发生率(2.50%)低于对照组(20.00%),差异有统计学意义(χ^(2)=6.135,P=0.013)。结论对PLG患者实施LC,可以减轻应激反应、炎症反应,减少术中出血量、手术时间及术后并发症,加快术后恢复速度。Objective To evaluate the clinical effect of laparoscopic cholecystectomy(LC)application in patients with polypoid lesions of the gallbladder(PLG)and the effect on stress reaction.Methods 80 cases of PLG patients admitted to Sanming First Hospital from December 2019 to December 2022 were randomly selected as the study objects,and the control group[40 cases,treated with open cholecystectomy(OC)]and the observation group(40 cases,treated with LC)were divided with reference to the random number table method.Surgery-related parameters,stress response,inflammatory response,and the incidence of postoperative complications were evaluated between the groups.Results Compared with the control group,the observation group had better surgical related parameters,and the differences were statistically significant(P<0.05).Before surgery,there was no statistically significant difference in stress response[including blood glucose(BG),cortisol(Cor),adrenaline(E)]and inflammatory response[including C-reactive protein(CRP),interleukin-6(IL-6),and interleukin-8(IL-8)]between the two groups(all P>0.05).After 1 day of surgery,the levels of stress response indicators(BG,Cor,E)and inflammatory factors(CRP,IL-6,IL-8)of the observation group were lower than those of the control group,and the differences were statistically significant(all P<0.05).The incidence of postoperative complications in the observation group(2.50%)was lower than that in the control group(20.00%),and the difference was statistically significant(χ^(2)=6.135,P=0.013).Conclusion The implementation of LC for PLG patients can reduce the stress reaction,inflammatory reaction,reduce intraoperative bleeding,operation time,postoperative complications,and accelerate postoperative recovery.

关 键 词：腹腔镜下胆囊切除术 胆囊息肉样病变 术中出血量 

分 类 号：R575.6[医药卫生—消化系统]