对比研究腹腔镜及开腹切除术对胆囊结石患者应激反应的影响

The Effect of Laparoscopic Cholecystectomy and Open Cholecystectomy on Stress Reaction

目的探讨腹腔镜及开腹切除术对胆囊结石患者应激反应的影响。方法选取来我院就诊行手术治疗的胆囊结石患者50例作为研究对象。按照手术方式的不同,将其分为观察组(32例,行腹腔镜胆囊切除术)和对照组(18例,行开腹胆囊切除术),观察两组患者手术情况及术后应激反应指标。结果观察组术中出血量、下床活动时间及住院时间均少/短于对照组,差异均具有统计学意义(P<0.05);观察组患者的平均手术时间长于照组,差异具有统计学意义(P<0.05);术后第1天,对照组患者的C反应蛋白、皮质醇、血糖水平均高于观察组,差异均具有统计学意义(P<0.05);与术后第1天相比,术后第7天两组患者3种指标水平显著下降,但对照组相应指标水平仍高于观察组,差异均具有统计学意义(P<0.05)。结论相比于开腹手术,腹腔镜胆囊切除术治疗胆囊结石对机体应激反应影响较小,有助于患者快速恢复。

Objective To observe the effect of laparoscopic cholecystectomy and open cholecystectomy on stress reaction of patients. Methods 50 cases of gallbladder stone patient treated by surgery in our hospital were selected as the study subjects. According to different operation methods, they were divided into observation group （32 cases underwent laparoscopic cholecystectomy） and control group （18 cases underwent open cholecystectomy）, the operation condition and stress response index of the two groups were observed. Results The amount of bleeding, the time of ambulation and the length of stay in the observation group were shorter / shorter than those in the control group, the difference was statistically significant （P〈0.05）. The average operation time of the observation group was longer than that of the treatment group, the difference was statistically significant （P〈0.05）. On the 1 day after operation, the C reactive protein, cortisol and blood sugar in the control group were higher than those in the observation group, the difference was statistically significant （P〈0.05）. Compared with the 1 day after operation, the 3 indexes of the two groups decreased significantly after 7 day, but the corresponding indexes in the control group were still higher than those in the observation group, the differences were statistically significant （P〈0.05）. Conelusion Compared with open surgery, laparoscopic cholecystectomy has little effect on the stress response, which can help patients recover quickly.