急诊手术联合生长抑素治疗急性胆囊炎对患者炎症状态、肝功能水平的影响

Effect of emergency operation combined with somatostatin therapy on inflammatory state and liver function levels in patients with acute cholecystitis

目的：研究急诊手术联合生长抑素治疗急性胆囊炎对患者炎症状态、肝功能水平的影响。方法：选择2012年5月~2015年10月期间在河北省张家口市第二医院接受腹腔镜下胆囊切除术的146例急性胆囊炎患者作为研究对象并分为生长抑素组和常规对照组,分析两组患者的手术情况、围手术期能量代谢以及术后炎症状态、肝功能水平。结果：生长抑素组的手术视野暴露清晰、局部组织的水肿和渗出程度较轻且中转开腹率较低;生长抑素组患者的围手术期REE均显著低于常规对照组;术后当天,生长抑素组患者的白细胞计数、中性粒细胞比值以及血清中抵抗素、超敏C反应蛋白、肿瘤坏死因子-α、白细胞介素-6、总胆红素、前碱性磷酸酶、丙氨酸氨基转移酶、天冬氨酸氨基转移酶的含量显著低于常规对照组,前白蛋白含量显著高于常规对照组。结论：围手术期应用生长抑素能够减轻机体的炎症反应、局部组织水肿以及肝功能损伤,是急性胆囊炎围手术期理想的治疗药物。

Objective：To study the effect of emergency operation combined with somatostatin therapy on inflammatory state and liver function levels in patients with acute cholecystitis.Methods：A total of 146 acute cholecystitis patients who ac-cepted laparoscopic cholecystectomy in our hospital from May 2012 to October 201 5 were selected as the research subjects and divided into somatostatin group and normal control group.Then the operation,perioperative energy metabolism as well as post-operative inflammatory state and liver function levels of the two groups were analyzed.Results：Operative field exposure of so-matostatin group was clearer,local tissue edema and exudation were lighter and conversion rate to laparotomy was lower;peri-operative REE of somatostatin group were significantly lower than those of normal control group;the very day after operation, numeration of leukocyte,neutrophil ratio as well as serum resistin,hypersensitive C-reactive protein and tumor necrosis factor-α,interleukin-6,total bilirubin,alkaline phosphatase,alanine aminotransferase and aspartate aminotransferase levels of soma-tostatin group were significantly lower than those of normal control group while prealbumin level was significantly higher than that of normal control group.Conclusions：Perioperative application of somatostatin can reduce the body＇s inflammatory re-sponse,local tissue edema and liver function injury.It is an ideal treatment for perioperative acute cholecystitis.