腹腔镜联合胆道镜下保胆取石术治疗对胆囊结石患者创伤应激指标、脂肪泻发生情况的影响  

Effects of Laparoscopic Combined with Choledochoscopy Gallbladder-Preserving Lithotomy on Traumatic Stress Indicators and Steatorrhea in Patients with Gallstones

作　　者：展宏图 程文龙 和树桦 ZHAN Hongtu;CHENG Wenlong;HE Shuhua(Department of General Surgery,Tai'an Central Hospital High-tech Campus,Tai'an 271000,China;Department of Anesthesiology,Tai'an Central Hospital,Tai'an 271000,China)

机构地区：[1]泰安市中心医院高新院区普外科,山东泰安271000 [2]泰安市中心医院手术麻醉科,山东泰安271000

出　　处：《反射疗法与康复医学》2024年第12期92-95,共4页Reflexology And Rehabilitation Medicine

摘　　要：目的探讨腹腔镜结合胆道镜下保胆取石术治疗对胆囊结石患者创伤应激指标、脂肪泻发生情况的影响。方法选取2021年1月—2022年12月泰安市中心医院收治的84例胆囊结石患者为研究对象,按随机数字表法将其分为对照组和观察组,各42例。对照组采用腹腔镜胆囊切除术治疗,观察组采用腹腔镜联合胆道镜下保胆取石术治疗。对比两组的围术期指标、创伤应激指标、生存质量及脂肪泻发生情况。结果观察组手术时间为(40.27±7.70)min,长于对照组的(28.94±5.37)min,术中出血量为(13.94±3.26)mL,少于对照组的(35.08±6.54)mL,术后肛门排气时间为(17.65±4.92)h,短于对照组的(25.78±6.33)h,组间差异有统计学意义(P<0.05)。术后3 d,观察组C反应蛋白、皮质醇、肾上腺素水平均低于对照组,组间差异有统计学意义(P<0.05)。术后3个月,观察组消化病生存质量指数评分低于对照组,差异有统计学意义(P<0.05)。观察组脂肪泻发生率为4.76%,低于对照组的21.43%,差异有统计学意义(P<0.05)。结论腹腔镜联合胆道镜下保胆取石术治疗胆囊结石可以减轻患者的创伤应激反应,减少术后脂肪泻发生情况,提高生存质量。Objective To investigate the effects of laparoscopic combined with choledochoscopy gallbladder-preserving lithotomy on traumatic stress index and steatorrhea in patients with gallstones.Methods A total of 84 patients with cholecystolithiasis treated in Tai'an Central Hospital from January 2021 to December 2022 were selected as the research objects,and were divided into a control group and an observation group according to random number table method,with 42 cases in each group.The control group was treated with laparoscopic cholecystectomy,and the observation group was treated with laparoscopic combined with choledochoscopy gallbladder-preserving lithotomy.Perioperative indicators,traumatic stress indicators,quality of life and steatosis were compared between the two groups.Results The operative time of the observation group was(40.27±7.70)min,which was longer than(28.94±5.37)min of the control group,the intraoperative blood loss was(13.94±3.26)mL,which was less than(35.08±6.54)mL of the control group,and the postoperative anal exhaust time was(17.65±4.92)h,which was shorter than(25.78±6.33)h of control group,and the differences between the groups were statistically significant(P<0.05).3 days after operation,the levels of C-reactive protein,cortisol and adrenaline in observation group were lower than those in control group,and the differences between the groups were statistically significant(P<0.05).3 months after operation,Gastrointestinal Quality of Life Index score of observation group was lower than that of control group,the difference was statistically significant(P<0.05).The incidence of steatosis in the observation group was 4.76%,which was lower than 21.43%in the control group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic combined with choledochoscopy gallbladder-preserving lithotorny can reduce the traumatic stress response,reduce the incidence of postoperative steatorrhea and improve the quality of life.

关 键 词：胆囊结石 脂肪泻 腹腔镜 胆道镜 保胆取石术 创伤应激 

分 类 号：R657.4[医药卫生—外科学]