腹腔镜胆囊切除术治疗胆囊结石患者效果及对患者应激反应和胃肠功能影响

Effect of laparoscopic cholecystectomy in the treatment of cholecystolithiasis and its effect on stress reaction and gastrointestinal function

目的探讨腹腔镜胆囊切除术治疗胆囊结石患者效果及对患者应激反应和胃肠功能影响。方法选取2012年6月~2016年6月期间收治的胆囊结石患者107例,按照随机数字表法分为观察组55例与对照组52例。对照组采用常规开腹胆囊切除术治疗,观察组采用腹腔镜胆囊切除术治疗。比较两组治疗疗效、手术相关指标、胃肠功能恢复情况、术后并发症情况及术前和术后3 d C反应蛋白(CRP)和白介素-6(IL-6)含量。结果观察组治疗总有效率(98.18%)高于对照组(84.62%)(P<0.05);观察组术后出血量少于对照组(P<0.05),住院时间短于对照组(P<0.05);两组手术时间比较无统计学差异(P>0.05);观察组肠鸣音恢复时间和排气时间快于对照组(P<0.05);观察组术后并发症发生率(9.09%)低于对照组(34.62%)(P<0.05);两组患者术后3 d CRP和IL-6含量增加(P<0.05);观察组患者术后3 d CRP和IL-6含量低于对照组(P<0.05)。结论腹腔镜胆囊切除术治疗胆囊结石患者效果明显,可明显改善患者胃肠功能,且对患者应激反应影响小,具有重要研究意义。

Objective To investigate the effect of laparoscopic cholecystectomy on eholecystolithiasis and its effect on patients＂ stress reaction and gastrointestinal function. Methods A total of 107 patients with cholecystolithias who were admitted to our hospital from June 2012 to June 2016 were selected.According to the random number table method,the patients were assigned to the observation group of 55 cases and the control group of 52 cases. The control group was given conventional open gallbladder stone lithotripsy, and the observation group was given laparoscopic cholecysteetomy. The curative effect,surgery-related indices, recovery of gastrointestinal function, postoperative complications, and levels of C-reactive protein（CRP） and interleukin-6（IL-6） before the surgery and 3d after the surgery were compared between the two groups. Results The total effective rate（98.18%） in the observation group was higher than that in the control group （84.62%） （P〈0.05）; the postoperative volume of bleeding in the observation group was less than that in the control group （P〈0.05）, and the length of stay was shorter than that in the control group （P〈0.05）. There was no significant difference in the operation time between the two groups（P〉0.05）; the recovery time of bowel sounds and time of passage of gas in the observation group were faster than those in the control group（P〈0.05）; the incidence rate of postoperative complications （9.09%） in the observation group was lower than that in the control group （34.62%）（P〈0.05）; the levels of 3d CRP and IL-6 in the two groups were increased （P〈0.05）; the levels of 3 d CRP and IL-6 in the observation group after the surgery- were lower than those in the control group （P〈0.05）. Conclusion Laparoscopic cholecystectomy is effective in the treatment of cholecystolithiasis,which can significantly improve the gastrointestinal function of the patients and has little effect on the stress reaction,showing an important research significance.