微创手术治疗老年胆总管结石的疗效及对CA19-9水平的影响

Application effect of minimally invasive surgery on patients with choledocholithiasis and the level of serum carbohydrate antigen 19-9

目的观察微创手术治疗胆总管结石的效果及对血清糖类抗原(CA)19-9水平的影响。方法选取胆总管结石患者90例,随机分为对照组(n=45)和观察组(n=45)。对照组采用开腹手术治疗,观察组采用微创手术治疗。采用放射免疫法测定CA19-9和癌胚抗原(CEA)水平,采用免疫比浊法测定C反应蛋白(CRP)水平,比较两组治疗效果及对血清CA19-9水平的影响。结果观察组手术时间、术中出血量、肛门排气时间及住院时间显著少于对照组(P<0.05);两组术前CA19-9、CEA及CRP水平差异无统计学意义(P>0.05);观察组术后CA19-9、CEA及CRP水平显著低于对照组(P<0.05);观察组术后并发症发生率为4.44%,显著低于对照组的17.78%(P<0.05)。结论胆总管结石患者采用微创手术治疗效果理想,能降低机体血清CA19-9水平。

Objective To observe the effect of minimally invasive surgery for choledocholithiasis patients and its effect on serum carbohydrate antigen 19-9 levels. Methods 90 patients with choledocholithiasis were randomly divided into control and observation groups （n =45 ）. Patients were treated with open surgery in control group, with minimally invasive surgery in observation group. CEA and CA19-9 levels were measured by radioimmunoassay, C-reactive protein（CRP） level was measured by immune turbidimetry. The effect of treatment and serum carbohydrate antigen 19-9 level of two groups were compared. Results The operation time, blood loss, anal exhaust time and hospital stay of observation group were significantly less than those of control group （P〈0.05）. There were no significant differences in CA19-9, CEA and CRP level between two groups before treatment （P〉0.05）. The levels of CA19-9, CEA and CRP in observation group were lower than those of control group （P〈0.05）. Postoperative complication rate of observation group was 4.44% , which was significantly iower than that of control group （ 17.78% , P〈0.05 ）. Conclusions Minimally invasive surgery treated for common bile duet stones patients could reduce serum carbohydrate antigen 19-9, which should be widely applied.