小切口胆囊切除与传统开腹胆囊切除创伤反应的前瞻性研究

ADVANCED STUDIES OF TRAUMA REACTION BETWEEN MINICHOLECYSTECTOMY AND TRADITIONAL CHOLECYSTECTOMY

97年3月至4月间，对因胆囊结石或胆囊息肉住院进行择期手术的40例患者，随机分为小切口胆囊切除组和传统开腹胆囊切除组，每组20例，进行围手术期多方面的检测。比较两组创伤反应大小。结果，体温、白细胞计数、潮气量、血浆ACTH和患者主诉疼痛方面，小切口组优于传统切口组。而在肺活量、24h尿游离皮质醇、β—内啡肽和肠功能恢复方面，两组无明显差异。作者认为，小切口胆囊切除在创伤反应某些方面优于传统切口。但手术创伤反应是短暂的，所以在遇到困难的情况下，及时延长切口仍是最明智的选择。

During March to April, 1997, 40 cases with cholelithiasis or polypoid lessions of the gallbladder were divided intominicholecystectomy group and traditional cholecystectomy group. Each group contains 20 cases. Many studies have been done during the perioperative period in order to explore whose trauma reaction is heavier. Conclusion: Minicholecystectomy is superior to traditional cholestectomy in body temperatare, leukocyta differential count,ACTH level of plasma,tidal volume and chief complainingpain. But there was no difference among vital capacity,urine free hydrocortisone of 24 hours,β-endorphin and restoration of bowelfunction. We reviewed that minicholecystectomy is superier to traditionl cholecystectomy in some of trauma reation,but trauma reaction is short,so to pand incision timely is the most sensible choice in difficult cases.