生长抑素联合消炎利胆片在急性结石性胆囊炎手术中的应用价值

Application Value of Somatostatin Combined with Xiaoyanlidan Tablet in the Operation of Acute Calculous Cholecystitis

目的:研究生长抑素联合消炎利胆片在急性结石性胆囊炎手术中的应用价值。方法:选择2016年8月~2019年8月我院进行胆囊切除术的301例急性结石性胆囊炎患者,随机分为两组。对照组围术期连续采用生长抑素治疗,术后连续用药3 d,初始剂量为250μg静脉注射,然后以3 mg的剂量静脉滴注,给药速度为250μg/h。观察组在生长抑素的基础上,术前7 d口服消炎利胆片,每天3次,每次6片,在饭前30 min服用,共计用药7 d。结果:观察组术后发热、切口感染和疼痛剧烈的发生率明显低于对照组(P<0.05);两组术前的血清降钙素原(procalcitonin,PCT)、C反应蛋白(C reactive protein,CRP)、促甲状腺激素(thyroid-stimulatinghormone,TSH)、血清血清癌抗原(cancer antigen19-9,CA19-9)、血清胰岛素(Insulin,Ins)水平无明显差异(P>0.05),术后1 d,两组的血清PCT、CRP水平明显升高(P<0.05),CA19-9、Ins和TSH水平明显降低(P<0.05),但两组相比无明显差异(P>0.05),术后7 d,两组的血清PCT、CRP、CA19-9、Ins和TSH水平均明显降低(P<0.05),且观察组明显低于对照组(P<0.05);术后7 d,两组的总胆红素(total bilirubin,TBil)、天冬氨酸转氨酶(Aspartate transaminase,AST)、碱性磷酸酶(alkaline phosphatase,AKP)、丙氨酸转氨酶(Alanine transaminase,ALT)水平明显降低(P<0.05),白蛋白(albumin,PA)水平明显升高(P<0.05),观察组的ALT、AKP、AST、TBil和PA水平明显优于对照组(P<0.05)。结论:生长抑素联合消炎利胆片在急性结石性胆囊炎手术中有较高的应用价值,能减少术后并发症,改善机体的炎症反应和肝功能。

Objective: To investigate the application value of somatostatin combined with Xiaoyanlidan tablet in the operation of acute calculous cholecystitis. Methods: From August 2016 to August 2019, 301 patients with acute calculous cholecystitis underwent cholecystectomy in our hospital were selected, divided into two groups randomly. The control group was treated with somatostatin for 3 days, the initial dose was 250 μg intravenously, then 3 mg intravenously, the speed of administration was 250 μg/h. On the basis of somatostatin, the observation group took Xiaoyan Lidan tablet 7 days before operation, 3 times a day, 6 tablets a time, 30 minutes before meals, a total of 7 days. Results: The incidence of postoperative fever, incision infection and severe pain in the observation group was significantly lower than that in the control group(P<0.05). There was no significant difference in the levels of PCT, CRP, CA19-9, ins and TSH between the two groups before operation(P>0.05). On the first day after operation, the levels of PCT, CRP, CA19-9, ins and TSH were significantly higher in the two groups(P<0.05), but there was no significant difference between the two groups(P>0.05). On the seventh day after operation, the levels of PCT, CRP, CA19-9, ins and TSH in the two groups were significantly lower than those in the observation group(P<0.05) Control group(P<0.05). 7 d after operation, the levels of alt, AKP, AST and TBIL in the two groups were significantly lower(P<0.05), and the levels of PA were significantly higher(P<0.05). The levels of alt, AKP, AST, TBIL and PA in the observation group were significantly higher than those in the control group(P<0.05). Conclusion: The combination of somatostatin and Xiaoyan Lidan tablet has high application value in the operation of acute calculous cholecystitis, which can reduce postoperative complications, improve the inflammatory response and liver function.