不同手术方式对老年胆囊切除患者应激反应和血糖水平的影响

Effect of different operation ways on stress reaction and glucose level of elderly patients with gallbladder surgery

目的：探讨不同手术方式对老年胆囊切除手术患者应激反应和血糖水平的影响。方法选取本院2011年12月~2013年12月行老年胆囊切除患者92例,采用数字随机法分为两组,对照组46例行开腹胆囊切除术,观察组46例行腹腔镜胆囊切除术,比较两组患者的应激反应情况（去甲肾上腺素、肾上腺素、皮质醇）、血糖情况、术后并发症情况、治疗效果。结果两组患者去甲肾上腺素、肾上腺素、皮质醇、血糖在T2时均显著升高,T4时达到最高。观察组患者去甲肾上腺素、肾上腺素、皮质醇、血糖在T2、T3、T4时均明显低于对照组,观察组患者术后并发症发生率明显低于对照组,观察组患者肠蠕动恢复时间、术后住院时间均明显短于对照组（P〈0.05）。结论与开腹胆囊切除术比较,腹腔镜胆囊切除术可明显减轻患者的应激反应,有助于稳定血糖。

Objective To explore the effect of different operation ways on stress reaction and glucose level of elderly patients with gallbladder surgery. Methods 92 elderly patients with gallbladder surgery from December 2011 to De-cember 2013 of our hospital were selected.Patients were divided into two groups according to random number table.46 patients in control group were given open cholecystectomy,46 patients in observation group were given laparoscopic cholecystectomy,stress reaction conditions liked noradrenaline,epinephrine and cortisol,condition of glucose,condition of complications after operation and therapy effect between two groups were compared. Results The noradrenaline,epinephrine, cortisol and glucose between two groups significantly increased at T2,and reached the highest at T4.The noradrenaline, epinephrine,cortisol and glucose in observation group were significantly lower than control group at T2,T3 and T4.The in-cidence of complications in observation group were significantly lower than control group,the time of the recovery of in-testinal peristalsis and post operation hospitalization duration in observation group were significantly lower than control group（P〈0.05）. Conclusion Compared with open cholecystectomy,laparoscopic cholecystectomy can significantly allevi-ate stress reaction of patients and contribute to stabilize blood sugar.