血清Ghrelin、GAS、CCK与保胆取石术后患者胃肠功能恢复的关系

Relationship between serum ghrelin,GAS,CCK and the recovery of gastrointestinal function in patients after cholecystolithotomy

目的分析胆结石患者血清胃饥饿素(Ghrelin)、胃泌素(GAS)、胆囊收缩素(CCK)水平与保胆取石术后胃肠功能恢复的关系。方法选取2019年1月至2020年12月本院收治的66例胆结石患者,均进行保胆取石术治疗,根据术后胃肠功能恢复情况将其分为功能恢复组和未恢复组,比较两组术后第一天血清Ghrelin、GAS和CCK水平以及手术方式、持续时间、术中出血量、术后开始下床活动时间,并采用多因素Logistic回归分析术后胃肠功能恢复的影响因素。结果功能未恢复组血清Ghrelin、GAS水平均低于功能恢复组,CCK水平高于功能恢复组,差异均有统计学意义(P<0.05)。功能未恢复组性别、高血压、糖尿病、BMI、文化程度、结石数目、结石大小、术前症状与功能恢复组比较差异无统计学意义(P>0.05),年龄、手术方式、手术持续时间、术中出血量、术后开始下床活动时间与功能恢复组比较差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,影响患者术后胃肠功能恢复的因素包括年龄、术式、手术持续时间、术中出血量、术后开始下床活动时间、血清Ghrelin、GAS和CCK水平(P<0.05)。结论监测术后第一天血清Ghrelin、GAS和CCK水平有助于预测胆结石患者保胆取石术后胃肠功能恢复状况。

Objective To analyze the correlation between serum ghrelin,gastrin(GAS)and cholecystokinin(CCK)levels in patients with gallstone and recovery of gastrointestinal function after cholecystolithotomy after gallbladder preservation.Methods A total of 66 patients with gallstones admitted to our hospital from January 2019 to December 2020 were selected for gallstone preservation and stone removal.According to the recovery of gastrointestinal function after surgery,the patients were divided into the recovered group and the non-recovered group.The levels of serum Ghrelin,GAS,and CCK on the first day after surgery were compared between the two groups,as well as the operation method,duration,intraoperative blood loss,and time to get out of bed after surgery.Multivariate Logistic regression was used to analyze the effect of postoperative gastrointestinal function recovery.Results The levels of serum Ghrelin and GAS in the function-unrecovered group were lower than those in the function-recovered group,and the CCK level was higher than that in the function-recovered group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in gender,hypertension,diabetes,BMI,education level,number of stones,stone size,preoperative symptoms between two groups(P>0.05).There were statistically significant differences in age,operation method,operation duration,intraoperative blood loss,and time to get out of bed after operation between two groups(P<0.05).Multivariate Logistic regression analysis showed that the factors affecting the recovery of gastrointestinal function after surgery included age,surgical method,operation duration time,intraoperative blood loss,postoperative time to get out of bed,serum ghrelin,GAS and CCK levels(P<0.05).Conclusion Monitoring the serum levels of ghrelin,GAS and CCK on the 1 st day after surgery can help predict the recovery of gastrointestinal function in patients with gallstones after cholecystolithotomy.