单孔与三孔腹腔镜胆囊切除的临床研究及术后血清TBA、ALT、AST、PA变化

Clinical Study of Single-hole and Three-hole Laparoscopic Cholecystectomy and Changes in Serum TBA,ALT,AST and PA after Operation

目的:探讨单孔与三孔腹腔镜胆囊切除的临床研究及术后血清总胆汁酸(TBA)、丙氨酸转氨酶(ALT)、谷草转氨酶(AST)、前白蛋白(PA)变化。方法:选择2019年9月-2020年12月在我院进行腹腔镜胆囊切除的102例患者,采用随机数表法分为单孔组(n=52)和三孔组(n=50)。三孔组给予常规三孔腹腔镜胆囊切除治疗,单孔组给予单孔腹腔镜胆囊切除治疗。比较两组手术情况、血清TBA、ALT、AST、PA、白细胞介素6(IL-6)、肿瘤坏死因子(TNF-α)、胃肠功能恢复情况及并发症发生情况。结果:治疗后,两组手术时间无显著差异单孔组切口长度、术中出血量显著低于三孔组,差异显著(P<0.05);治疗前,单孔组和三孔组TBA、ALT、AST、PA比较无显著差异;治疗后,单孔组和三孔组血清TBA、ALT、AST、PA均随着时间的推移而升高,且单孔组血清TBA、ALT、AST低于三孔组,PA高于三孔组,差异显著(P<0.05);治疗前,单孔组和三孔组IL-6、TNF-α比较无显著差异;治疗后,单孔组和三孔组血清IL-6、TNF-α均随着时间的推移而降低,且单孔组低于三孔组,差异显著(P<0.05);单孔组术后肠鸣音恢复时间、肛门排气时间及首次排便时间均显著低于三孔组,差异显著(P<0.05);单孔组术后并发症显著低于三孔组,差异显著(P<0.05)。结论:单孔腹腔镜胆囊切除可有效改善患者术后血清TBA、ALT、AST、PA水平,缩短胃肠恢复,促进患者康复。

Objective:To study Clinical study of single-hole and three-hole laparoscopic cholecystectomy and changes in serum Total bile acid(TBA),alanine aminotransferase(ALT),aspartate aminotransferase(AST),prealbumin(PA)after operation.Methods:102 patients who underwent laparoscopic cholecystectomy in our hospital from September 2019 to December 2020 were selected and divided into the single-hole group(n=52)and the three-hole group(n=50)by random number table method.The three-hole group was treated with conventional three-hole laparoscopic cholecystectomy,while the single-hole group was treated with single-hole laparoscopic cholecystectomy.The operative conditions,serum TBA,ALT,AST,PA,interleukin-6(IL-6),tumor necrosis factor(TNF-α),gastrointestinal function recovery and complications were compared between the two groups.Results:After treatment,there was no significant difference in operation time between the two groups.The incision length and intraoperative blood loss in the single-hole group were significantly lower than those in the three-hole group(P<0.05).Before treatment,there was no significant difference in TBA,ALT,AST and PA between the single-well group and the three-well group.After treatment,the serum TBA,ALT,AST,and PA levels of the monopole and triopole groups increased with the passage of time,and the serum TBA,ALT,and AST levels of the monopole group were lower than those of the triopole group,and the serum PA levels of the monopole group were higher than those of the triopole group,with significant differences(P<0.05).Before treatment,there was no significant difference in IL-6 and TNF-αbetween the single-well group and the three-well group.After treatment,serum IL-6 and TNF-of the monopole group and the triopole group decreased with the passage of time,and the monopole group was lower than the triopole group,with significant differences(P<0.05).Postoperative bowel sound recovery time,anal exhaust time and first defecation time in the single-hole group were significantly lower than those in the three-hole group(P<0.05).Postoperative complications in the single-hole group were significantly lower than those in the three-hole group(P<0.05).Conclusion:Single-port laparoscopic cholecystectomy can effectively improve postoperative serum TBA,ALT,AST and PA levels,shorten gastrointestinal recovery,and promote patients’recovery.