不同入路腹腔镜胆囊切除术治疗胆囊结石合并慢性胆囊炎的疗效及安全性分析  

Analysis of the Efficacy and Safety of Laparoscopic Cholecystectomy via Different Approaches in the Treatment of Cholelithiasis Complicated by Chronic Cholecystitis

作　　者：王福鑫 田学昌 王明辉 WANG Fuxin;TIAN Xuechang;WANG Minghui(Department of Hepatobiliary Surgery,Ansteel Group General Hospital,Anshan,Liaoning,114000,China)

机构地区：[1]鞍钢集团公司总医院肝胆外科,辽宁鞍山114000

出　　处：《中外医疗》2025年第6期25-29,共5页China & Foreign Medical Treatment

摘　　要：目的比较不同入路腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)对胆囊结石合并慢性胆囊炎的疗效与安全性。方法选取2023年8月—2024年8月鞍钢集团公司总医院收治的110例胆囊结石合并慢性胆囊炎患者作为研究对象,根据手术入路进行分组,对照组(n=55)采取经胆囊前三角入路进行手术,研究组(n=55)采取经胆囊后三角入路进行手术。比较两组手术相关指标、疼痛情况、炎症因子、氧化应激指标,记录并发症。结果相较于对照组手术时间的(54.12±6.43)min、术中出血量的(48.62±5.29)mL与胃肠功能恢复时间的(8.06±1.42)h,研究组为(30.89±5.21)min、(33.47±4.86)mL与(6.35±1.07)h,均较优,差异均有统计学意义(t=20.817,15.641,7.133;P均<0.05)。术后4 h、6 h、12 h、24 h,研究组疼痛评分均低于对照组,差异均有统计学意义(P均<0.05)。术后,相较于术前,两组患者的炎症水平(白细胞介素-2、白细胞介素-6,C反应蛋白)与氧化应激指标(皮质醇、丙二醛)均上升,且对照组高于研究组,差异均有统计学意义(P均<0.05)。相较于对照组的16.36%(9/55),研究组的并发症总发生率为3.64%(2/55),更低,差异有统计学意义(χ^(2)=4.949,P<0.05)。结论对胆囊结石合并慢性胆囊炎患者予以经胆囊后三角入路LC治疗,更有助于改善手术情况,减轻术后疼痛,抑制术后炎症与氧化应激反应,降低相关并发症发生率,安全性更高。Objective To compare the efficacy and safety of laparoscopic cholecystectomy(LC)via different approaches in the treatment of cholelithiasis complicated by chronic cholecystitis.Methods A total of 110 patients with cholelithiasis complicated by chronic cholecystitis who were admitted to the Ansteel Group General Hospital of from August 2023 to August 2024 were selected as the research subjects.They were divided into groups according to the surgical approach.The control group(n=55)underwent surgery via the anterior gallbladder triangle approach,and the study group(n=55)underwent surgery via the posterior gallbladder triangle approach.The operation-related indicators,pain conditions,inflammatory factors,and oxidative stress indicators of the two groups were compared,and complications were recorded.Results Compared with the operation time was(54.12±6.43)min,the intraoperative blood loss was(48.62±5.29)mL,and the gastrointestinal function recovery time was(8.06±1.42)h of the control group,the(30.89±5.21)min,(33.47±4.86)mL,and(6.35±1.07)h of the study group were better,and the differences were statistically significant(t=20.817,15.641,7.133;all P<0.05).At 4 h,6 h,12 h,and 24 h after surgery,the pain scores of the study group were lower than those of the control group,and the differences were statistically significant(all P<0.05).After surgery,compared with before surgery,the inflammatory levels(interleukin-2,interleukin-6,C-reactive protein)and oxidative stress indicators(cortisol,malondialdehyde)of the two groups of patients increased,and those of the control group were higher than those of the study group,and the differences were statistically significant(all P<0.05).The total complication rate of the study group was 3.64%(2/55),which was lower than 16.36%(9/55)of the control group,and the difference was statistically significant(χ^(2)=4.949,P<0.05).Conclusion For patients with cholelithiasis complicated by chronic cholecystitis,LC via the posterior gallbladder triangle approach is more conducive to improving

关 键 词：胆囊结石 慢性胆囊炎 腹腔镜 胆囊切除术 疼痛程度 炎症 

分 类 号：R657[医药卫生—外科学]