不同Calot三角解剖入路腹腔镜胆囊切除术对胆囊结石患者创伤应激反应及ICAM-1、MPO水平的影响

Influences of laparoscopic cholecystectomy through different Calot triangle anatomical approaches on the traumatic stress response,ICAM-1 and MPO levels of patients with gallbladder stone

目的探讨不同Calot三角解剖入路腹腔镜胆囊切除术治疗胆囊结石的效果。方法选取2018年12月至2020年12月收治的200例胆囊结石患者作为研究对象,以随机数字表法将其分为A、B组,各100例。两组均接受腹腔镜胆囊切除术治疗,A组采用胆囊后三角解剖入路,B组采用胆囊前三角解剖入路,比较两组手术效果。结果A组的手术时间、住院时间短于B组,术中出血量少于B组,术后6、12及24 h的VAS评分低于B组(P<0.05)。术后1 d,A组的CRP、Cor、E、ICAM-1、MPO水平均低于B组(P<0.05)。结论相较于胆囊前三角解剖入路,胆囊后三角解剖入路腹腔镜胆囊切除术治疗胆囊结石更具有优势,能缩短手术时间,减少术中出血,促进术后恢复,也能减轻创伤应激反应,降低ICAM-1、MPO水平,值得临床推广。

Objective To explore the effects of laparoscopic cholecystectomy through different Calot triangle anatomical approaches in the treatment of gallbladder stone.Methods A total of 200 patients with gallbladder stone admitted from December 2018 to December 2020 were selected as the study objects and divided into group A and group B by random number table method,with 100 cases in each group.Both groups were treated with laparoscopic cholecystectomy.The group A was treated with posterior triangle anatomical approach of gallbladder,and the group B was treated with anterior triangular anatomical approach of gallbladder.The surgical effects of the two groups were compared.Results The operation time and hospital stay of the group A were shorter than those of the group B,the intraoperative blood loss was less than that of the group B,and the VAS score at 6,12 and 24 h after operation were lower than those of the group B(P<0.05).At 1 d after operation,the levels of CRP,Cor,E,ICAM-1 and MPO in the group A were lower than those in the group B(P<0.05).Conclusion Compared with the anterior triangular anatomical approach of gallbladder,the posterior triangular anatomical approach of gallbladder laparoscopic cholecystectomy has more advantages in the treatment of gallbladder stone,it can shorten the operation time,reduce intraoperative blood loss,promote postoperative recovery,reduce traumatic stress response and the levels of ICAM-1 and MPO,which is worthy of clinical promotion.