小切口直视下胆囊切除术与腹腔镜胆囊切除术的比较研究  

COMPARITION OF MINI-INCISION CHOLECYSTECTOMY AND LAPAROSCOPIC CHOLECYSTECTOMY-ANALYSES OF TWO KINDS OF MICROTRAUMIC CHOLECYSTECTOMY

作　　者：李爱东[1] 许评[1] 宋春芳[1] 韩礼欧[1] 季洪亮[1] 张健[1] 张景欣[2] 

机构地区：[1]哈尔滨医科大学附属第一临床医学院普外一科,哈尔滨150001 [2]黑龙江中医药大学附属第一医院普外科

出　　处：《中国内镜杂志》2003年第4期34-36,共3页China Journal of Endoscopy

摘　　要：目的 :比较小切口胆囊切除术 (MC)与腹腔镜胆囊切除术 (LC)创伤应激反应的程度差异、代谢改变以及术式特点。方法 :选择 6 2例慢性胆囊炎、胆囊结石、胆囊息肉患者 ,随机分为MC组和LC组 ,每组各 31例 ,围手术期分别测定血清胰岛素、生长激素、皮质醇水平 ,并监测手术前后动脉血气和酸碱平衡 ,记录平均手术时间、肠蠕动恢复时间及住院时间和医疗费用。结果 :MC与LC组创伤应激反应的程度无显著差异。PO2 在MC组围手术期无明显变化 ,LC组术后第 1天明显下降。SO2 2组术后第 1天均较术前明显下降 ,第 3天 2组均恢复至术前水平。H2 CO3 和BE在LC组术后第 3天明显低于MC组 ,pH值在LC组术后第 1天明显低于MC组。MC与LC两种术式在手术时间、肠蠕动恢复时间以及住院时间上无显著差异 ,但在医疗费用方面LC明显高于MC。结论 :MC与LC所引起的创伤应激反应的程度相近 ,MC对呼吸及代谢的影较LC小 ,与LC相比MC更为安全、简单、经济并且适应症广泛。Objective:Compare the degree of trauma stress reaction, metabolic change and operation characters of mini-incision cholecystectomy (MC) and laparoscopic cholecystectomy(LC) .Methods: Sixty-two patients of chronic cholecystitis, gall stones and gall polyp were divided into two groups, each 31. Serum insulin, growth hormone, corticosteroids,artery blood analysis ,acid-alkaline balance, mean operation time, time of bowl function recovery, hospitalized time and medical expenses were detected. Results: There is no dominant differences of degree of trauma stress reaction between MC and LC groups. Perioperative PO 2changed little in MC group, but decreased sharply from the first postoperative day in LC group.SO 2 decreased obviously from the 1st postoperative day in both groups and recovered to preoperative levels until the 3rd postoperative day. HCO 3 and BE were much lower in LC group than MC group in the 3rd postoperative. PH level was much lower in LC group in the 1st postoperative day. There were no differences of operation time, time of bowl function recovery and hospitalized time in two groups but medical expense was much higher in LC group than MC group.Conclusions: The degree of trauma stress reaction caused by MC and LC is similar.Influence caused by MC is much less than LC. Compared with LC, MC is more safety,easy ,commercial and has wider indications.

关 键 词：小切口 腹腔镜 胆囊切除术 

分 类 号：R657.4[医药卫生—外科学]