胆囊管汇入部微切开在腹腔镜探查胆道取石术中的应用效果及对血清PCT及CRP水平的影响

Application effect of micro-incision of the cystic duct confluence in laparoscopic exploration biliary stone removal and its influences on serum PCT and CRP levels

目的探讨胆囊管汇入部微切开在腹腔镜探查胆道取石术中的应用效果及对血清PCT及CRP水平的影响。方法选取2016年9月至2019年5月本院诊治的122例胆囊结石患者作为研究对象,根据随机数字表法将其分为对照组与观察组,各61例。对照组给予常规腹腔镜探查胆道取石术,观察组给予基于胆囊管汇入部微切开的腹腔镜探查胆道取石术。比较两组的应用效果。结果两组的结石清除率比较,差异无统计学意义(P>0.05)。观察组的术后24 h引流量少于对照组,术后肛门排气时间、下床活动时间与术后住院时间均短于对照组(P<0.05)。观察组的并发症总发生率低于对照组(P<0.05)。术后1、7 d,观察组的血清PCT、CRP及IL-6水平均低于对照组(P<0.05);两组术后7 d的血清PCT、CRP及IL-6水平均低于术后1 d(P<0.05)。结论胆囊管汇入部微切开应用于腹腔镜探查胆道取石术中能促进胆囊结石患者的康复,降低血清炎症因子水平及并发症的发生率,值得临床推广应用。

Objective To explore the application effect of micro-incision of the cystic duct confluence in laparoscopic exploration biliary stone removal and its influences on serum PCT and CRP levels.Methods A total of 122 patients with cholecystolithiasis admitted in our hospital from September 2016 to May 2019 were selected as the research objects,and the patients were divided into control group and observation group according to random number table method,with 61 cases in each group.The control group was given conventional laparoscopic exploration biliary stone removal,and the observation group was given laparoscopic exploration biliary stone removal based on the micro-incision of the cystic duct confluence.The application effects of the two groups were compared.Results There was no significant difference in stone clearance rate between the two groups(P>0.05).The postoperative 24 h drainage volume in the observation group was less than that in the control group,and the postoperative anal exhaust time,ambulation time and postoperative hospitalization time were shorter than those in the control group(P<0.05).The total incidence of complications in the observation group was lower than that in the control group(P<0.05).At 1 and 7 d after operation,the levels of serum PCT,CRP and IL-6 in the observation group were lower than those in the control group(P<0.05);and the levels of serum PCT,CRP and IL-6 in the two groups at7 d after operation were lower than those at 1 d after operation(P<0.05).Conclusion Micro-incision of the cystic duct confluence applied in laparoscopic exploration biliary stone removal can promote the recovery of patients with cholecystolithiasis,reduce the levels of serum inflammatory factors and incidence of complications,which is worthy of clinical promotion and application.