腹腔镜胆囊切除术对老年胆囊结石患者机体应激的影响

Efficacy of physical stress in laparoscopic cholecystectomy on elderly patients with gallstone

目的：探讨腹腔镜胆囊切除术对老年胆囊结石患者机体应激的影响。方法选取2012年4月至2014年3月老年胆囊结石患者76例，随机分为两组，每组38例。腹腔镜组采用腹腔镜胆囊切除术，开放术组给予开放胆囊切除术，比较两组手术指标、应激指标。结果腹腔镜组手术时间、术中出血量、住院天数分别为（38.4±12.7）h、（34.9±10.1）ml、（7.6±2.2）d，少于开放术组，差异有统计学意义（P ＜0.05）。腹腔镜组术后1 d 白细胞介素-6、C-反应蛋白、血糖、皮质醇分别为（115.8±13.5）ng/ L、（17.3±3.2）mg/ L、（7.4±0.9）mmol/ L、（73.2±25.4）ng/ ml，均低于开放术组，差异有统计学意义（P ＜0.05）。结论腹腔镜胆囊切切除术治疗胆囊结石切口小、应激反应低，有利于老年患者机体的恢复。

Objective To investigate the effect of physical stress in laparoscopic cholecystectomy on senile patients with gallstone. Methods Seventy-six senile patients with gallstone from April 2012 to March 2014 were selected,and were randomly divided into two groups,with 38 cases in each group. Laparoscope group was given laparoscopic cholecystectomy,open surgery group was treated by open chol-ecystectomy. Operation and stress indexes were compared between the two groups. Results The operative time,intraoperative blood loss,length of hospital stay of the laparoscope group were（38. 4 ± 12. 7）h,（34. 9 ± 10. 1）ml,（7. 6 ± 2. 2）d,which were less than those of the open surgery group,the differences were significant（P 〈 0. 05）. In postoperative 1 d,interleukin-6,C-reactive protein,blood glucose and cortisol of the laparoscope group were（115. 8 ± 13. 5）ng / L,（17. 3 ± 3. 2）mg / L,（7. 4 ± 0. 9）mmol/ L,（73. 2 ± 25. 4）ng / ml,which were lower than those of the open surgery group,the differences were significant（P 〈 0. 05）. Conclusions Laparoscopic cholecystectomy has advantages of small incision,low stress reaction degree. It is conducive to the recovery of body,and is worth clinical application and promotion.