急性胆囊炎患者经腹腔镜下三孔法胆囊切除术治疗的效果及安全性

The efficacy and safety of three-port laparoscopic cholecystectomy in patients with acute cholecystitis

目的对比三孔法与四孔法腹腔镜胆囊切除术(LC)治疗急性胆囊炎(AC)患者的效果和安全性。方法选取焦作市人民医院2018年8月至2020年8月收治的90例AC患者作为研究对象,计算机随机数表法均分为试验组(n=45)和对照组(n=45)。对照组行四孔法LC手术治疗,试验组行三孔法LC手术治疗。检测两组术前1 d、术后3 d血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、干扰素(TNF-α)水平,记录两组手术时长、术中出血量、胃肠道功能恢复时间、住院时间、住院费用,比较两组术后感染、胆漏等并发症发生情况。结果术前1 d,两组血清CRP、IL-6、TNF-α水平差异无统计学意义(P>0.05);术后3 d,试验组血清CRP、IL-6、TNF-α水平均低于对照组(P<0.05);试验组手术时长短于对照组,住院费用少于对照组(P<0.05);两组术中出血量、胃肠道功能恢复时间、住院时间差异无统计学意义(P>0.05);两组并发症发生率差异无统计学意义(P>0.05)。结论三孔法LC具有手术时间短,住院费用低,安全性较高的特点,用于治疗AC是安全有效的。

Objective To compare the efficacy and safety of three-port and four-port laparoscopic cholecystectomy(LC)in the treatment of patients with acute cholecystitis(LC).Methods A total of 90 AC patients admitted to our hospital from August 2018 to August 2020 were selected as the research objects.All of them were divided into experimental group(n=45)and control group(n=45)by computer random table method.The control group received four-port LC surgery,and the experimental group received three-port LC surgery.The serum levels of C-reaction protein(CRP),interleukin(IL-6)and interferon(TNF)-αwere detected 1 d before surgery and 3 d after surgery.The operation time,intraoperative blood loss,recovery time of gastrointestinal function,hospitalization time,hospitalization expenses were recorded.The incidence of postoperative complications such as infection and bile leakage was compared between the two groups.Results 1 day before operation,there was no significant difference in serum CRP,IL-6,and TNF-αlevels between the two groups(P>0.05).3 days after operation,serum CRP,IL-6,and TNF-αlevels in the experimental group were lower than those in the control group Group(P<0.05).The experimental group had shorter operation time than the control group,and the hospitalization cost was less than the control group(P<0.05).There was no difference in intraoperative blood loss,recovery time of gastrointestinal function and length of hospital stay between the two groups(P>0.05).There was no difference in the total incidence of complications between the two groups(P>0.05).Conclusion Three-port LC has the characteristics of short operation time,low hospitalization cost,and high safety.It is safe and effective for the treatment of AC.