保胆手术对胆囊良性病变患者的疗效及生活质量的影响

Effect of gallbladder preserving operation on the curative effect and quality of life in patients with benign gallbladder disease

目的:探讨保胆手术对胆囊良性病变患者的临床疗效及生活质量的影响,为胆囊良性病变患者的临床治疗提供参考。方法:选择96例胆囊良性病变患者作为研究对象,随机分为观察组和对照组两组,每组各48例,其中对照组患者给予腹腔镜下胆囊切除术治疗,观察组患者给予腹腔镜联合胆道镜保胆术治疗,比较两组患者的手术相关指标情况,观察两组患者治疗前后的血脂水平、胆囊收缩功能以及视觉模拟评分(VAS)和KPS生活质量评分的变化,比较两组患者治疗后的并发症发生情况。结果:两组患者治疗前后血清TG、LDL、TC水平无显著变化,而治疗前的胆囊收缩相关指标以及KPS生活质量评分比较差异无统计学意义(P> 0. 05);治疗后,观察组患者的血清HDL水平明显低于对照组,差异具有统计学意义(P <0. 05);治疗后,两组患者的血清Leptin及CCK水平明显降低,且观察组改善更为显著(P <0. 05);与对照组相比,观察组患者术后的VAS评分明显较低,且术后1周VAS评分降低更为显著(P <0. 05),且KPS生活质量评分明显高于对照组(P <0. 05);与对照组相比,观察组患者的住院时间、排便时间、手术时间、以及、出血量以及术后并发症明显较低(P <0. 05)。结论:腹腔镜联合胆道镜保胆手术治疗胆囊良性病变患者,可以显著减轻其术后疼痛,改善血脂代谢和胆囊收缩功能,减少并发症,提高术后生活质量,效果显著。

Objective:To explore the effect of gallbladder surgery on the clinical efficacy and quality of life of patients with benign gallbladder disease,and to provide reference for the clinical treatment of benign gallbladder disease.Methods:96 patients with gallbladder benign lesions were selected as study subjects.They were randomly divided into observation group and control group,with 48 cases in each group.Among the patients in the control group,laparoscopic cholecystectomy was performed.In the observation group,laparoscopy combined with choledochoscopy was used to treat gallbladder.The related indexes of the two groups were compared.The blood lipid levels,gallbladder systolic function,visual analogue scale(VAS)and KPS quality of life scores were observed before and after treatment in the two groups.The complications after treatment were compared between the two groups.Results:There was no significant change in serum TG,LDL and TC levels before and after treatment in the two groups,however,there was no significant difference in the index of gallbladder contraction and KPS quality of life score before treatment(P>0.05).The serum HDL level in the observation group after treatment was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).After treatment,serum Leptin and CCK levels were significantly lower in the two groups,and the improvement in the observation group was more significant(P<0.05).Compared with the control group,the postoperative VAS scores were significantly lower in the observation group,and the VAS score decreased more significantly at 1 week postoperatively(P<0.05),the KPS quality of life score was significantly higher than that of the control group(P<0.05).Compared with the control group,the length of hospitalization,defecation time,operation time,blood loss and postoperative complications were significantly lower in the observation group(P<0.05).Conclusion:Laparoscopy combined with choledochoscope preservation of gallbladder surgery for gallbladder benign lesions can significantly reduce postoperative pain,improve lipid metabolism and gallbladder systolic function,reduce complications and improve postoperative quality of life.