两种手术方式用于胆结石患者的术后恢复情况、血清皮质醇及FT3水平比较

Comparison between the effects of two surgical procedures on postoperative recovery, serum cortisol and FT3 levels in the patients with gallstones

目的比较两种手术方式用于胆结石患者的术后恢复情况、血清皮质醇及FT3(游离三碘甲状腺原氨酸)水平。方法选取2013年1月~2015年12月我院收治的68例胆结石患者作为研究对象,根据不同的治疗方法分为实验组与对照组(每组34例)。对照组应用传统开腹胆囊切除联合胆总管切开取石术,实验组应用腹腔镜胆囊切除联合胆总管切开取石术。分析两组患者的术后恢复情况(术后排气时间、平均住院时间、镇痛药物用量、术后胃肠道功能恢复时间、并发症发生率)、血清皮质醇及游离三碘甲状腺原氨酸水平等参数指标。结果 (1)实验组患者术后排气时间、平均住院时间、镇痛药物用量、术后胃肠道功能恢复时间显著优于对照组患者(P<0.05);(2)实验组患者并发症发生率显著低于对照组患者(P<0.05);(3)手术前,两组患者的血清皮质醇及游离三碘甲状腺原氨酸水平比较差异无统计学意义(P>0.05);手术后4 d,实验组患者的水平比较稳定,对照组患者水平变化较大(P<0.05)。结论腹腔镜胆囊切除联合胆总管切开取石术的术后效果显著优于传统开腹胆囊切除联合胆总管切开取石术。

Objective To compare the effects of two surgical procedures on the postoperative recovery, serum cortisol and FT3（free triiodothyronine） levels in the patients with gallstones. Methods A total of 68 patients with gallstones who were admitted to our hospital from January 2013 to December 2015 were selected as the research subjects. According to different treatment methods, the patients were divided into the experimental group and the control group, with 34 patients in each group. The control group was given conventional open cholecystectomy combined with choledocholithotomy. The experimental group was given laparoscopic cholecystectomy combined with choledocholithotomy. The postoperative recovery （postoperative exhaust time, mean length of stay, analgesic drug dosage, postoperative gastrointestinal function recovery time, incidence rate of complications）, serum cortisol, free triiodothyronine levels and other parameters were analyzed. Results ① The postoperative exhaust time, average length of stay, analgesic drug dosage and postoperative gastrointestinal function recovery time in the experimental group were significantly better than those in the control group（P〈0.05）; ② The incidence rate of complications in the experimental group was significantly lower than that in the control group（P〈0.05）; ③ there was no statistically significant difference in serum cortisol and free triiodothyronine levels between the two groups before the surgery（P〉0.05）; at 4 days after the surgery, the level of the patients in the experimen- tal group was stable and the level in the control group was changed significantly （P〈0.05）. Conclusion The postopera- tive effect of laparoscopic cholecystectomy combined with choledocholithotomy is superior to that of conventional open cholecystectomy combined with choledocholithotomy.