腹腔镜胆总管探查术后创伤应激、胃肠动力相关指标的变化研究

Changes of postoperative traumatic stress and gastrointestinal motility related indicators in patients undergoing laparoscopic exploration of common bile duct

目的 探讨腹腔镜胆总管探查术后创伤应激、胃肠动力相关指标的变化情况.方法 以2016年5月至2019年5月本院行胆总管探查术治疗的94例患者为对象,按不同术式分作两组,对照组47例术式为开腹胆总管探查术,试验组47例术式为腹腔镜胆总管探查术,对比两组手术前后创伤应激、胃肠动力学情况.结果 术后,试验组促肾上腺皮质激素、皮质醇、多巴胺水平较对照组低,差异有统计意义(P<0.05);术后,试验组胃泌素、血管活性肠肽水平水平较对照组高,差异有统计意义(P<0.05);试验组术后肛门排气、肠鸣音恢复、正常饮食恢复、胃肠减压、下床活动及住院的时长均较对照组短,差异有统计意义(P<0.05).结论 腹腔镜胆总管探查术对患者术后创伤应激、胃肠动力影响较小,可促进患者术后康复时间缩短.

Objective To investigate the changes of postoperative traumatic stress and gastrointestinal motility related indicators in patients undergoing laparoscopic exploration of common bile duct.Methods A total of 94 patients who underwent exploration of common bile duct in our hospital from May 2016 to May 2019 were enrolled.According to the different surgical procedures,they were divided into two groups.47 patients in the control group were underwent open exploration of common bile duct,and 47 patients in the experimental group were underwent laparoscopic exploration of common bile duct.The traumatic stress and gastrointestinal dynamics were compared before and after surgery.Results After operation,the levels of adrenocorticotropic hormone,cortisol and dopamine in the experimental group were lower than those in the control group,with statistically significant(P<0.05).After operation,the levels of gastrin and vasoactive intestinal peptide in the experimental group were higher than those in the control group,with statistically significant(P<0.05).Postoperative anal exhaust,bowel sound recovery,normal diet recovery,gastrointestinal decompression,getting out of bed and hospitalizationin the experimental group were shorter than those in the control group,with statistically significant(P<0.05).Conclusion Laparoscopic exploration of common bile duct has bettereffect on postoperative traumatic stress and gastrointestinal motility,which can promote the shortening of postoperative recovery time.