腹腔镜下开窗引流术对肝囊肿患者术后康复及预后的影响

Effect of Laparoscopic Fenestration and Drainage on Postoperative Rehabilitation and Prognosis of Patients with Hepatic Cyst

目的探究腹腔镜下开窗引流术治疗肝囊肿的效果。方法选取2018年10月至2019年10月方城县人民医院收治的98例肝囊肿患者为研究对象,按随机数表法分为开腹组和腹腔镜组,各49例。开腹组接受开腹开窗引流术,腹腔镜组接受腹腔镜下开窗引流术。比较两组围手术期指标(术中出血量、手术、下床活动、住院时间)、术后1、3 d疼痛程度[视觉模拟量表(VAS)评分]、应激反应[血清C反应蛋白(CRP)、皮质醇(Cor)、血糖水平]、并发症发生率及复发率。结果腹腔镜组术中出血量少于开腹组,手术时间、下床活动时间、住院时间均短于开腹组(P<0.05);术后1、3 d腹腔镜组VAS评分低于开腹组(P<0.05);腹腔镜组并发症发生率(4.08%)低于开腹组(16.33%)(P<0.05);术后1 d腹腔镜组CRP、Cor、血糖水平低于开腹组(P<0.05);腹腔镜组复发率(4.17%)与开腹组(10.64%)比较,差异无统计学意义(P>0.05)。结论腹腔镜下开窗引流术治疗肝囊肿效果确切,可促进患者恢复,减轻应激反应,减少并发症的发生,且复发率低。

Objective To explore the effect of laparoscopic fenestration drainage in the treatment of hepatic cyst.Methods A total of 98 patients with hepatic cyst in Fangcheng People’s Hospital from October 2018 to October 2019 were selected as the research objects,and they were divided into open group and laparoscopic group according to random number table,49 cases in each group.Open fenestration drainage was used in the open group,and laparoscopic fenestration drainage was used in the laparoscopic group.The perioperative indicators(intraoperative blood loss,operation time,getting out of bed,length of hospital stay),pain degree[visual analogue scale(VAS)score]and,stress response[serum C-reactive protein(CRP),cortisol(Cor),blood glucose levels]complication rate and recurrence rate on 1 and 3 days after surgery were compared between the two groups.Results The intraoperative blood loss of the laparoscopic group was less than that of open group,and the operation time,time getting out of bed and hospital stay were shorter than those in open group(P<0.05).VAS score of laparoscopic group was lower than that of open group on 1 and 3 days after operation(P<0.05).The complication rate of the laparoscopic group(4.08%)was lower than that in open group(16.33%)(P<0.05).The levels of CRP,Cor and blood glucose in laparoscopic group were lower than those in open group on 1 day after operation(P<0.05).Compared with the recurrence rate in the laparoscopic group(4.17%)and open group(10.64%),there was no significant difference between the two groups(P>0.05).Conclusion The application of laparoscopic fenestration and drainage to hepatic cyst can improve the surgical effect,promote recovery,relieve stress response,reduce the incidence of complications,and have a low recurrence rate.