腹腔镜胆囊切除术对结石性胆囊炎患者炎性因子及胃肠功能的影响

Effect of Laparoscopic Cholecystectomy on the Inflammatory Factors and Gastrointestinal Function in Patients with Calculous Cholecystitis

目的探讨腹腔镜胆囊切除术对结石性胆囊炎患者炎性因子及胃肠功能的影响。方法选择我院2013年6月至2017年6月收治的120例结石性胆囊炎患者,均予以腹腔镜胆囊切除术治疗,分析患者的手术情况、手术前后炎性因子水平、胃肠功能指标及并发症情况。结果术后,患者的白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平均显著高于术前,差异有统计学意义(P<0.05)。术后,患者的胃动素(MTL)及胃泌素(GAS)水平均较术前显著下降(P<0.05)。患者的并发症以皮下气肿、胆道损伤为主,无肠瘘、胆管狭窄、肠梗阻、肠粘连等并发症发生。结论腹腔镜胆囊切除术具有微创优势,能够减轻术后炎性反应程度,促进胃肠功能恢复,可作为结石性胆囊炎患者的理想术式。

Objective To explore the effect oflaparoscopic cholecystectomy on the inflammatory factors and gastrointestinal function in patients with calculous cholecystitis. Methods 120 cases of patients with calculous cholecystitis admitted to our hospital from June 2013 to June 2017 were selected. All patients were treated with laparoscopic cholecystectomy. The operation conditions, gastrointestinal function indicators, complications, and inflammatory factors before and after operation were analyzed. Results After operation, the levels of interleukin-6 （IL-6）, C-reactive protein （CRP） and tumor necrosis factor-a （TNF-a） were significantly higher than those before operation （P 〈0.05）. After operation, the levels of motilin （MTL） and gastrin （GAS） were significantly lower than those before operation （P 〈0.05）. The main complications of patients were subcutaneous emphysema and biliary tract injury, without intestinal fistula, bile duct stricture, intestinal obstruction, intestinal adhesion or other complications. Conclusions Laparoscopic cholecystectomy has minimally invasive advantages in reducing the degree of postoperative inflammatory response and promoting the recovery of gastrointestinal function, which can be used as an ideal operation for patients with calculous cholecystitis.