单孔腔镜、三孔腔镜胆囊切除术与开腹胆囊切除术对胆囊炎伴胆结石患者应激反应水平及胃肠道功能的影响  

The eff ects of single port laparoscopic cholecystectomy,triple port laparoscopic cholecystectomy,and open cholecystectomy on stress response levels and gastrointestinal function in patients with cholecystitis and gallstones

作　　者：万宏 Wan Hong(General Surgery Department of Yixing Integrated Traditional Chinese and Western Medicine Hospital,Jiangsu Yixing 214200,China)

机构地区：[1]宜兴市中西医结合医院普外科,江苏宜兴214200

出　　处：《临床普外科电子杂志》2025年第1期2-6,共5页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：目的分析在胆囊炎伴胆结石患者中分别采取单孔腔镜、三孔腔镜胆囊切除术与开腹胆囊切除术治疗的效果并作对比分析。方法选取宜兴市中西医结合医院在2022年1月至2024年1月接诊的胆囊炎伴胆结石患者共计93例纳入研究中,按照不同的手术形式分为三组,分别对应开腹组(31例)、三孔腔镜组(31例)、单孔腔镜组(31例),各予以开腹胆囊切除术、三孔腹腔镜胆囊切除术及单孔腔镜胆囊切除术治疗,对比三组围手术期指标、应激反应指标、胃肠道功能及美观程度。结果三孔腔镜组与单孔腔镜组手术时间、切口长度均短于开腹组,且术中失血量少于开腹组,差异均有显著性(P<0.05);三孔腔镜组、单孔腔镜组C反应蛋白、皮质醇、去甲肾上腺素水平均优于开腹组,且单孔腔镜组上述3项指标优于三孔腔镜组,差异均有显著性(P<0.05);三孔腔镜组、单孔腔镜组胃排空率、胃窦收缩次数、胃体蠕动次数均高于开腹组,且单孔腔镜组上述3项指标均高于三孔腔镜组(P<0.05);单孔腔镜组术后美观程度均优于三孔腔镜组、开腹组(P<0.05)。结论虽然小切口胆囊切除术、腹腔镜胆囊切除术治疗效果大体相近,均能够有效治疗胆囊炎伴胆结石疾病。但相较于小切口胆囊切除术,腹腔镜胆囊切除术所带来的创伤更小,且术后恢复情况更好。其中,单孔腔镜胆囊切除的优势更为明显,且不仅术后恢复情况更好,且美观度更高。Objective To analyze and compare the eff ects of single port laparoscopic cholecystectomy,triple port laparoscopic cholecystectomy,and open cholecystectomy in patients with cholecystitis and gallstones.Method A total of 93 patients with cholecystitis and gallstones who were treated in Yixing Integrated Traditional Chinese and Western Medicine Hospital from January 2022 to January 2024 were selected and included in the study.They were divided into three groups according to diff erent surgical forms,corresponding to open surgery group(31 cas-es),three port laparoscopic group(31 cases),and single port laparoscopic group(31 cases),and each group was treated with open cholecystectomy,three port laparoscopic cholecystectomy,and single port laparoscopic cholecys-tectomy.The perioperative indicators,stress response indicators,gastrointestinal function,and aesthetic degree were compared among the three groups.Result The surgical time and incision length of the three port endoscopy group and the single port endoscopy group were lower than those of the open surgery group,and the intraoperative blood loss was lower than that of the open surgery group,with signifi cant diff erences(P<0.05);The levels of C-reactive protein,cortisol,and norepinephrine in the three port endoscopic group and the single port endoscopic group were all higher than those in the open surgery group, and the single port endoscopic group had signifi cantly higher levels of these three indicators than the three port endoscopic group (P < 0.05);The gastric emptying rate, number of gastric antral contractions, and number of gastric body peristalsis in the three port endoscopic group and the single port endoscopic group were all higher than those in the open surgery group, and the above three indicators were all higher in the single port endoscopic group than in the three port endoscopic group (P < 0.05);The postoperative aesthetic degree of the single hole endoscopic group was better than that of the three hole endoscopic group and the open surgery group (P

关 键 词：胆囊炎 胆结石 腹腔镜胆囊切除术 单孔腔镜 三孔腔镜 应激反应 胃肠道功能 

分 类 号：R657.4[医药卫生—外科学]