腹腔镜胆囊切除术治疗对老年非急性胆囊炎患者围术期指标及预后的影响

Effect of Laparoscopic Cholecystectomy on Perioperative Indexes and Prognosis of Elderly Patients with Non-acute Cholecystitis

目的:探讨腹腔镜胆囊切除术的实施方法及其对老年非急性胆囊炎患者围术期指标与预后效果的影响。方法:选取2019年1月~2021年1月间接受治疗的非急性胆囊炎患者90例作为研究对象,按照随机数表法分为对照组和观察组各45例,对照组进行常规开腹手术,观察组应用腹腔镜胆囊切除术治疗。比较两组患者术中指标、术后恢复情况以及体力与生活质量评分,检测并比较术前3d和手术后7d的免疫指标。结果:观察组手术时间、切口长度、术后进食时间和术后住院时间均显著短于对照组(P<0.05)。术后7d两组TNF-α、IL-6显著高于术前3d(P<0.05),并且术后7d观察组TNF-α、IL-6显著低于对照组(P<0.05);对照组患者术前3d与术后7d的CD4+和CD8+指标差异不明显(P>0.05),观察组患者术后7d的CD4+和CD8+指标较与术前3d有显著降低,术后7d观察组CD4+和CD8+显著低于对照组(P<0.05)。与对照组比,观察组KPS评分及QOL评分均相对较高(P<0.05)。结论:腹腔镜胆囊切除术可显著改善围术期指标,提高患者体力与生活质量评分以及免疫力,更有利于患者术后恢复。

Objective:To investigate the effect of laparoscopic cholecystectomy on perioperative indexes and prognosis of elderly patients with non-acute cholecystitis.Methods:A total of 90 patients with non-acute cholecystitis who received treatment from January 2019 to January 2021 were divided into two groups according to random number table method,with 45 cases in each group.The control group received conventional open surgery,and the observation group received laparoscopic cholecystectomy.The intraoperative indicators,postoperative recovery,physical strength and quality of life scores of the two groups were compared,and the immune indexes at 3d before surgery and 7d after surgery were detected and compared.Results:The operation time,incision length,postoperative feeding time and postoperative hospitalization time in the observation group were significantly shorter than those in the control group(P<0.05).TNF-αand IL-6 in two groups at 7d after surgery were significantly higher than those at 3d before surgery(P<0.05),and TNF-αand IL-6 in observation group were significantly lower than those in control group at 7d after surgery(P<0.05).There was no significant difference in CD4+and CD8+at 7d after surgery compared with 3d before surgery in the control group(P>0.05),CD4+and CD8+at 7d after surgery in the observation group were significantly decreased compared with 3d before surgery,and the CD4+and CD8+at 7d after surgery in the observation group were significantly lower than those in the control group(P<0.05).Compared with the control group,the KPS score and QOL score of the observation group were relatively higher(P<0.05).Conclusion:Laparoscopic cholecystectomy can significantly improve perioperative indicators,physical strength,quality of life score and immunity of patients,and is more conducive to postoperative recovery of patients.