高清腹腔镜胆囊切除术经胆囊后三角解剖入路治疗急性结石性胆囊炎的效果及对患者炎性水平和胃肠功能的影响研究  

Effect of High-definition Laparoscopic Cholecystectomy Via Posterior Triangle Anatomical Approach of the Gallbladder in the Treatment of Acute Calculous Cholecystitis and Its Influence on Inflammatory Level and Gastrointestinal Function of Patients

作　　者：唐志国[1] 张金刚 TANG Zhiguo;ZHANG Jingang(Department of General Surgery,Panyu Hospital of Traditional Chinese Medicine,Guangzhou,Guangdong,511400,China)

机构地区：[1]广州市番禺区中医院普通外科,广东广州511400

出　　处：《中外医疗》2024年第32期38-41,共4页China & Foreign Medical Treatment

摘　　要：目的探讨高清腹腔镜经胆囊后三角解剖入路治疗急性结石性胆囊炎的临床效果。方法回顾性选取2020年4月—2023年1月广州市番禺区中医院普外科收治的78例急性结石性胆囊炎患者的临床资料,根据手术方案的不同将其分为观察组(41例)和对照组(37例),观察组行高清腹腔镜下后三角解剖入路,对照组行胆囊三角解剖入路。比较两组的手术相关指标、炎性介质水平、胃肠道功能恢复时间、胃肠功能评级、并发症发生率。结果观察组的切口长度、手术时间、术中失血量、住院时间均优于对照组,差异有统计学意义(P均<0.05)。术后,观察组的白细胞介素-6、肿瘤坏死因子-α和C反应蛋白水平均低于对照组,差异有统计学意义(P均<0.05)。观察组胃肠功能恢复时间短于对照组,差异有统计学意义(P<0.05)。术后,观察组胃肠功能分级优于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为2.44%(1/41),对照组为13.51%(5/37),两组比较,差异无统计学意义(χ2=1.981,P=0.159)。结论高清腹腔镜胆囊切除术经胆囊后三角解剖入路治疗急性结石性胆囊炎整体效果显著,能更好地控制患者的炎性介质水平并加快胃肠道功能的恢复。Objective To investigate the clinical effect of high-definition laparoscopic cholecystectomy via posterior triangle anatomical approach in the treatment of acute calculous cholecystitis.Methods The clinical data of 78 patients with acute calculous cholecystitis admitted to the Department of General Surgery in Panyu Hospital of Traditional Chinese Medicine of Guangzhou from April 2020 to January 2023 were retrospectively selected and divided into observation group(41 cases)and control group(37 cases)according to different surgical procedures.The observation group underwent high-definition laparoscopic cholecystectomy via posterior triangle anatomical approach,and the control group underwent gallbladder triangle anatomical approach.The operation-related indicators,the level of inflammatory mediators,gastrointestinal function recovery time,gastrointestinal function rating,and incidence of complications were compared between the two groups.Results The incision length,operation time,intraoperative blood loss and hospitalization time of the observation group were better than those of the control group,and the differences were statistically significant(all P<0.05).After operation,the levels of interleukin-6,tumor necrosis factor-αand C-reactive protein in the observation group were lower than those in the control group,and the differences were statistically significant (all P<0.05). The recovery time of gastrointestinal function in the observation group was shorter than that in the control group, the difference was statistically significant (P<0.05). After operation, the gastrointestinal function grading of the observation group was better than that of the control group, and the difference was statistically significant (P< 0.05). The incidence of complications was 2.44% (1/41) in the observation group and 13.51% (5/37) in the control group, there was no significant difference between the two groups (χ2=1.981, P=0.159). Conclusion The overall effect of high-definition laparoscopic cholecystectomy via posterior triangle

关 键 词：急性结石性胆囊炎 高清腹腔镜 腹腔镜胆囊切除术 炎症水平 胃肠功能 

分 类 号：R657.4[医药卫生—外科学]