腹腔镜与开腹胆囊切除术不同术式对急性胆囊炎患者胃肠道功能及炎症因子水平的影响

Effect of laparoscopic cholecystectomy and open cholecystectomy on gastrointestinal function and the level of inflammatory factors in patients with acute cholecystitis

目的 探讨腹腔镜与开腹胆囊切除术不同术式对急性胆囊炎患者胃肠道功能及炎症因子水平的影响.方法 选取2014年3月至2016年7月71例急性胆囊炎患者,根据手术术式不同分为对照组35例和观察组36例.对照组予以传统开腹胆囊切除术治疗,观察组实施腹腔镜胆囊切除术治疗.观察比较两组胃肠道功能恢复情况及血清C-反应蛋白（CRP）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）水平变化情况,并统计两组并发症发生情况及生活质量评分.结果 治疗后观察组肛门排气时间、肛门排便时间、肠鸣音恢复时间及进食时间均短于对照组,差异有统计学意义（P〈0.05）;治疗后观察组CRP、IL-6、IL-8、TNF-α水平均低于对照组,差异有统计学意义（P〈0.05）;观察组并发症发生率为5.56%,低于对照组（25.71%）,差异有统计学意义（P〈0.05）;观察组治疗后生活质量评分高于对照组,差异有统计学意义（P〈0.05）.结论 腹腔镜胆囊切除术治疗急性胆囊炎效果优于开腹胆囊切除术,可有效改善患者炎症因子水平,促进胃肠道功能恢复,提高生活质量,且并发症发生率低,安全性高.

Objective To investigate the effects of laparoscopic cholecystectomy and open cholecystectomy on gastrointestinal function and inflammatory factors levels in patients with acute cholecystitis.Methods Seventy-one patients with acute cholecystitis from March 2014 to July 2016 were divided into control group and observation group, with 35 cases in the control group and 36 cases in the observation group.The control group was treated by conventional open cholecystectomy, and the observation group was treated by laparoscopic cholecystectomy.The gastrointestinal function recovery and serum C reactive protein （CRP）, interleukin-6 （IL-6）, interleukin-8（IL-8）, tumor necrosis factor alpha （TNF-alpha） levels change between the two groups were compared.The incidence of complications and quality of life of the two groups were statistically analyzed.Results After treatment, the anal exhaust time, defecation time, recovery time of bowel sound and eating time in observation group were less than those in control group, the differences were significant （P〈0.05）.After treatment, the levels of CRP, IL-6, IL-8, TNF-α of observation group were lower than those of control group, the differences were significant （P〈0.05）.The incidence of complication in observation group was 5.56%, which was lower than that in control group （25.71%）, the difference was significant （P〈0.05）.The quality of life of observation group was better than that of control group （P〈0.05） Conclusions Laparoscopic cholecystectomy is better than open cholecystectomy in the treatment of acute cholecystitis, and it can effectively improve the level of inflammatory factors.It can promote the recovery of gastrointestinal function and improve the quality of life, the incidence of complications is low and with high security.