腹腔镜胆囊切除术联合经胆囊管胆总管探查术对胆囊并胆总管结石患者TBIL、GGT、AST、ALT水平影响

Effect of Laparoscopic Cholecystectomy Combined With Common Bile Duct Exploration on the Levels of TBIL,GGT,AST,and ALT in Patients With Gallbladder and Com mon Bile Duct Stones

目的探究腹腔镜胆囊切除术联合经胆囊管胆总管探查术对胆囊并胆总管结石患者总胆红素(TBIL)、谷氨酰转肽酶(GGT)、天冬氨酸转氨酶(AST)、丙氨酸转移酶(ALT)水平影响。方法选取2019年1月至6月在商洛市中心医院进行治疗的112例胆囊结石伴胆总管结石患者,按照随机数字表法将其分为试验组和对照组,各56例。对照组采用传统开腹手术治疗,试验组采用腹腔镜胆囊切除术联合经胆囊管胆总管探查取石术治疗。比较两组临床疗效及手术指标,比较术前及术后1 d血清TBIL、GGT、AST、ALT水平变化,比较治疗过程中并发症发生情况。结果试验组治疗有效率100.00%显著高于对照组(89.29%)(P<0.05);试验组手术时间、住院时间均显著短于对照组,术中出血量显著低于对照组(P<0.05);与术前比,术后Id两组血清TBIL、GGT、AST、ALT水平均升高,但试验组显著低于对照组(P<0.05);试验组并发症发生率5.36%显著低于对照组23.21%(P<0.05)。结论腹腔镜胆囊切除术联合经胆囊管胆总管探查术治疗效果显著,创伤小,患者术后恢复快,且不易损伤肝脏功能,并发症较少,安全性良好。

Objectve To investigate the effect of laparoscopic cholecystectomy combined with common bile duct exploration on the levels of TBIL,GGT,AST and ALT in patients with gallbladder and comon bile duct stones.Methods A total of 112 patients with gallbladder stones and common bile duct stones treated in Shangluo Central Hospital from January to June 2019 and divided into experimental group and control group according to the random number table method,with 56 cases in each group.The contro1 group was treated with traditional laparotomy,and the experimental group was treated with 1 aparoscapie cholecystectomy combined with common bile duct exploration and lithatripsy.Compared the clinical efficacy and surgical indicators of the two groups,compared the changes of serum TBIL,GGT,AST,and ALT levels before and after 1 day,and compared the occurrence of comp1ications during the treatment.Results The treatment effective rate of the experimental group 100.00%was si gnificantly hi gher than that of the control group 89.29%(P<0.05);The operation time and hospital stay of the experimental group were significantly shorter than those of the control group,and the intraoperative blood loss was significantly lower than that of the control group(P<0,05).Compared with the preoperative group,the serum TBIL,GGT,AST,and ALT levels in the two groups were si gnificantly 1ower than those before the operation,but the exper imental group was significantly lower than the control group(P<0.05);The probability of complications in the experimental group 5.36% was significantly lower than that in the control group 23.21%(P<0.05),Conclusion Laparoscopic chol ecystectomy combined with common bile duct exploration has si gnificant curative effects,less trauma,qui cker postoperative recovery,less danage to liver function,fewer comp1 ications and good safety.