经脐单孔腹腔镜手术治疗急性胆囊炎患者的有效性及对血清淀粉酶水平的影响

The Effectiveness of Transumbilical Single Port Laparoscopic Surgery in Patients with Acute Cholecystitis and Its Effect on Serum Amylase Levels

目的探讨经脐单孔腹腔镜手术治疗急性胆囊炎患者的有效性及对血清淀粉酶水平的影响。方法选取2018年1月~2019年11月我院收治的80例急性胆囊炎患者作为研究对象,按手术方法不同分为研究组和对照组,每组40例。对照组予以腹腔镜胆囊切除术治疗,研究组予以经脐单孔腹腔镜手术治疗,比较两组手术情况、血清淀粉酶(AMY)和血清脂多糖(LPS)水平、健康调查简表评分、术后并发症发生率、肝功能指标以及炎症反应指标。结果研究组术中失血量、手术用时、术后疼痛时间、住院时间均少于对照组,下床活动时间早于对照组,差异有统计学意义(P<0.05);研究组AMY、LPS水平低于对照组,差异有统计学意义(P<0.05);研究组并发症总发生率为7.50%,低于对照组的27.50%,差异有统计学意义(P<0.05)。研究组SF-36躯体疼痛、躯体功能、生命活力、精神健康评分高于对照组,差异有统计学意义(P<0.05);研究组术后C反应蛋白、白细胞计数、碱性磷酸酶、门冬氨酸氨基转移酶、谷丙转氨酶均优于对照组,差异有统计学意义(P<0.05)。结论经脐单孔腹腔镜手术治疗急性胆囊炎可有效减少患者术中失血量,缩短手术用时、术后疼痛时间、住院时间,降低血清淀粉酶、脂多糖水平及并发症发生率,提高患者的生活质量,保护患者肝功能。

Objective To investigate the effectiveness of transumbilical single port laparoscopic surgery in the treatment of patients with acute cholecystitis and its effect on serum amylase levels.Methods A total of 80 patients with acute cholecystitis admitted to our hospital from January 2018 to November 2019 were selected as the research objects.They were divided into study group and control group according to different surgical methods,with 40 cases in each group.The control group was treated with laparoscopic cholecystectomy,and the study group was treated with transumbilical single-port laparoscopic surgery.The operation conditions,serum amylase(AMY)and serum lipopolysaccharide(LPS)levels,health survey scores,and surgery were compared between the two groups.The incidence of post-complication,liver function indicators and inflammatory response indicators.Results Intraoperative blood loss,operation time,postoperative pain time,and hospital stay in the study group were less than those in the control group,and the time to get out of bed was earlier than the control group,the difference was statistically significant(P<0.05);the study group had low levels of AMY and LPS in control group,the difference was statistically significant(P<0.05);the total incidence of complications in the study group was 7.50%,which was lower than 27.50% in the control group,the difference was statistically significant(P<0.05).The scores of SF-36 physical pain,physical function,vitality,and mental health of the study group were higher than those of the control group,the difference was statistically significant(P<0.05);the study group had C-reactive protein,white blood cell count,alkaline phosphatase,gate both aspartate aminotransferase and alanine aminotransferase were better than the control group,the difference was statistically significant(P<0.05).Conclusion Transumbilical single port laparoscopic surgery for acute cholecystitis can effectively reduce intraoperative blood loss,shorten the operation time,postoperative pain,and hospital stay,reduce serum amylase,lipopolysaccharide levels and complication rates,and improve patients'health Quality of life,protect the liver function of patients.