胆囊切除术对胆囊结石患者胃肠功能及预后的影响  

Effect of Cholecystectomy on Gastrointestinal Function and Prognosis in Patients with Gallstones

作　　者：邓明敏 DENG Mingmin(The First Department of Surgery,Fengxin County Hospital of Traditional Chinese Medicine,Fengxin 330700,Jiangxi,China)

机构地区：[1]奉新县中医院外一科,江西奉新330700

出　　处：《医学信息》2025年第9期114-116,124,共4页Journal of Medical Information

摘　　要：目的分析胆囊切除术对胆囊结石患者胃肠功能及预后的影响。方法选取2022年8月-2023年8月我院诊治的61例胆囊结石患者为研究对象,采用随机数字表法分为对照组(n=30)和观察组(n=31),对照组采用常规开腹胆囊切除术,观察组采用腹腔镜胆囊切除术,比较两组临床手术指标、胃肠功能指标[胃动素(MTL)、胃泌素(GAS)]、应激反应指标[内皮素(ET)、皮质醇(Cor)、超氧化物歧化酶(SOD)]、并发症发生率、复发率。结果与对照组比较,观察组手术时间、首次排气时间及住院时间更短、术中出血量更少(P<0.05);两组术后MTL、GAS均低于术前,但与对照组比较,观察组术后MTL、GAS更高(P<0.05);与对照组比较,观察组术后ET、Cor更低,SOD更高(P<0.05);与对照组并发症发生率的16.67%,观察组并发症发生率更低,为6.45%(P<0.05);随访5个月,观察组复发率与对照组比较,差异无统计学意义(P>0.05)。结论胆囊切除术可缩短手术时间、术后首次排气时间、住院时间,减少术中出血量,减轻应激反应,且对胃肠功能影响小,另可实现与开腹切除术基本相同的预后效果,值得临床应用。Objective To analyze the effect of cholecystectomy on gastrointestinal function and prognosis in patients with gallstones.Methods A total of 61 patients with gallstones diagnosed and treated in our hospital from August 2022 to August 2023 were selected as the research objects.They were divided into control group(n=30)and observation group(n=31)by random number table method.The control group was treated with conventional open cholecystectomy,and the observation group was treated with laparoscopic cholecystectomy.The clinical operation indexes,gastrointestinal function indexes[motilin(MTL),gastrin(GAS)],stress response indexes[endothelin(ET),cortisol(Cor),superoxide dismutase(SOD)],complication rate and recurrence rate were compared between the two groups.Results Compared with the control group,the operation time,first exhaust time and hospitalization time of the observation group were shorter,and the intraoperative blood loss was less(P<0.05).After surgery,the levels of MTL and GAS in the two groups were lower than those before surgery,but compare with the control group,the levels of MTL and GAS in the observation group were higher(P<0.05).Compared with the control group,ET and Cor in the observation group were lower,and SOD was higher after surgery(P<0.05).Compared with 16.67%of the control group,the incidence of complications in the observation group was lower(6.45%)(P<0.05).After 5 months of follow-up,there was no significant difference in the recurrence rate between the observation group and the control group(P>0.05).Conclusion Cholecystectomy can shorten the operation time,postoperative first exhaust time,hospitalization time,reduce intraoperative blood loss,reduce stress response,and has little effect on gastrointestinal function.In addition,it can achieve the same prognosis as laparotomy,which is worthy of clinical application.

关 键 词：胆囊切除术 胆囊结石 胃肠功能 

分 类 号：R657.4[医药卫生—外科学]