腹腔镜胆囊切除术患者术后胃肠道功能恢复情况的观察

Observation on the recovery of gastrointestinal function of patients after laparoscopic cholecystectomy

目的 研究腹腔镜胆囊切除术对患者术后胃肠道功能恢复情况的影响.方法 将2011年6月～2013年10月在本院进行胆囊切除术的患者168例随机分成两组,各84例,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,比较两组患者胃肠道功能（腹胀、食欲、呕吐、肠鸣音恢复时间、排气时间、排便时间）情况及术前、术后胃肠激素（血清胃动素、胃泌素、血管活性肠肽及生长抑素）水平.结果 观察组肠鸣音恢复时间、排气时间及排便时间均显著短于对照组（P＜0.05）;观察组腹胀、呕吐及食欲差的发生率显著低于对照组（P＜0.05）;术后24、48 h,观察组胃动素、胃泌素水平显著高于对照组,血管活性肠肽水平显著低于对照组（P＜0.05）.结论 腹腔镜胆囊切除术与常规开腹胆囊切除术相比,对患者的胃肠道功能影响小,患者术后胃肠道功能恢复快.

Objective To study the influence of laparoscopic cholecystectomy on the recovery of gastrointestinal func- tion of patients. Methods 168 patients received laparoscopic cholecystectomy from July 2011 to October 2013 in our hospital were randomly divided into two groups,each group of 84 cases.Open cholecystectomy treatment was used in control group,laparoscopic eholecystectomy treatment was applied in observation group.The gastrointestinal function such as bloating,loss of appetite,vomiting,recovery time of bowel sounds,flatus and anal defecation in two groups were compared.The gastrointestinal hormone levels such as motilin,gastrin,vasoactive intestinal peptide and somatostatin in two groups before and after cholecystectomy were compared. Results The recovery time of bowel sounds,flatus and anal defecation in observation group was significantly shorter than that in control group respectively （P〈0.05）.The incidence rate of bloating,vomiting,loss of appetite was significantly lower than that in control group respectively（P〈0.05）.At 24,48 hours,the serum level of motilin and gastrin in observation group was significantly higher than that in control group re- spectively,the serum level of vasoactive intestinal peptide was significantly lower than that in control group （P〈0.05）. Conclusion Compared with conventional open cholecystectomy,laparoscopic cholecystectomy has a smaller tract on the function of the gastrointestinal,and patients will get a faster recovery of gastrointestinal function.