腹腔镜胆囊切除术对急性胆囊炎患者胃肠功能及炎症因子水平的影响

Effect of laparoscopic cholecystectomy on gastrointestinal function and inflammatory factor levels in patients with acute cholecystitis

目的探讨腹腔镜胆囊切除术(LC)对急性胆囊炎患者胃肠功能及炎症因子水平的影响。方法回顾性分析2017年11月~2019年11月锦州市中心医院收治的300例急性胆囊炎患者资料,依据手术方式不同分为对照组(145例)与观察组(155例)。对照组采用3孔LC治疗,观察组采用单孔LC治疗。比较两组患者围术期指标,胃肠功能,术前、术后3 d炎症因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白介素-6(IL-6)]变化情况以及并发症发生情况。结果观察组手术用时、排气时间及住院时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);观察组肠鸣音恢复时间、进食时间及排便时间短于对照组,差异有统计学意义(P<0.05);术后3 d,两组CRP、TNF-α及IL-6水平低于术前,且观察组CRP、TNF-α及IL-6水平低于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论急性胆囊炎患者采用单孔LC治疗效果良好,可减少手术时间与住院时间,改善胃肠功能与炎症因子水平,减少术后并发症,利于患者预后,值得临床推广。

Objective To explore the effect of laparoscopic cholecystectomy(LC)on gastrointestinal function and levels of inflammatory factors in patients with acute cholecystitis.Methods A total of 300 patients with acute cholecystitis admitted to Jinzhou Central Hospital from November 2017 to November 2019 were retrospectively analyzed.According to different surgical methods,they were divided into the control group(145 cases)and the observation group(155 cases).Three-hole LC was used in the control group,and in the observation group,single-hole LC was adopted.The perioperative indicators,gastrointestinal function and changes of inflammatory factors mainly including C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)before surgery and 3 days after surgery,and complications of the two groups were compared.Results The operation time,exhaust time and hospital stay of the observation group were shorter than those of the control group,and the bleeding volume during operation was less than that of the control group,the differences were statistically significant(P<0.05).The recovery time of bowel sounds,food ingestion time and defecation time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The levels of CRP,TNF-αand IL-63 days after surgery were lower than those before operation,and the levels of CRP,TNF-αand IL-6 in the observation group were lower than the control group at 3 days after surgery,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was lower than the control group,and the difference was statistically significant(P<0.05).Conclusion The effect of single-hole LC in patients with acute cholecystitis is favorable,which can significantly reduce the operation time and hospital stay,improve gastrointestinal function and the levels of inflammatory factors,decrease postoperative complications,and faciliate the prognosis of patients.It is worthy of clinical promotion.