胆囊结石患者胆囊收缩功能与术后排便功能的相关性分析

Correlation between gallbladder systolic function and postoperative defecation function in patients with gallstone

目的探讨胆囊结石患者胆囊收缩功能与术后排便功能的相关性。方法120例胆囊结石患者,均行腹腔镜胆囊切除术。观察患者围手术期指标;对比手术前后胆囊收缩功能指标(空腹胆囊容积、胆囊最小剩余容积、胆囊收缩指数)变化情况;分析胆囊收缩功能指标与术后排便功能障碍发生率的相关性。结果所有患者均顺利完成手术,无中转开腹患者。平均手术时间为(65.10±12.77)min,平均术中出血量为(32.89±10.48)ml,平均术后住院时间为(4.20±0.29)d。术后未发生胆瘘、发热、切口感染、胆道感染等并发症。患者术前1 d及术后1、3个月的空腹胆囊容积对比差异无统计学意义(P>0.05);术后1、3个月,患者胆囊最小剩余容积大于术前1 d,胆囊收缩指数低于术前1 d,差异均有统计学意义(P<0.05)。术后1个月,患者发生腹泻6例,便秘6例,排便功能障碍发生率为10.0%;术后3个月,患者发生腹泻4例,便秘3例,排便功能障碍发生率为5.8%。Pearson相关性分析显示:术后1、3个月,胆囊最小剩余容积与术后排便功能障碍发生率呈正相关性(r=0.667、0.532,P<0.05);胆囊收缩指数与术后排便功能障碍发生率呈负相关性(r=-0.492、-0.422,P<0.05)。结论腹腔镜胆囊切除术治疗胆囊结石的成功率高,但是术后排便功能障碍比较常见,与术后胆囊收缩功能有显著相关性。

Objective To discuss the correlation between gallbladder systolic function and postoperative defecation function in patients with gallstone.Methods 120 patients with gallstones underwent laparoscopic cholecystectomy.The perioperative indicators of patients were observed.The changes of gallbladder systolic function indicators(fasting gallbladder volume,minimum residual volume of gallbladder and gallbladder systolic indicator) before and after the surgery were compared.The correlation between gallbladder systolic function indicators and the incidence of postoperative defecation dysfunction was analyzed.Results All patients successfully received the surgery without conversion to laparotomy.The average surgery time was(65.10±12.77) min,the average intraoperative bleeding amount was(32.89±10.48) ml,and the average postoperative hospital stay was(4.20±0.29) d.There were no complications such as biliary fistula,fever,incision infection and biliary tract infection.The differences in fasting gallbladder volume on 1 d before the surgery and 1 and 3 months after the surgery were not statistically significant(P>0.05).1 and 3 months after the surgery,the minimum residual volume of gallbladder was greater than that on 1 day before the surgery,and the gallbladder systolic indicator was lower than that on 1 d before the surgery;and the differences were statistically significant(P<0.05).1 month after the surgery,6 patients had diarrhea,6 patients had constipation,and the incidence of defecation dysfunction was 10.0%.3 months after the surgery,4 patients had diarrhea,3 patients had constipation,and the incidence of defecation dysfunction was 5.8%.Pearson correlation analysis showed:1 and 3 months after the surgery,the minimum residual volume of gallbladder was positively correlated with the incidence of defecation dysfunction(r=0.667,0.532,P<0.05),gallbladder systolic indicator was negatively correlated with the incidence of postoperative defecation dysfunction(r=-0.492,-0.422,P<0.05).Conclusion Laparoscopic cholecystectomy has high success rate in the treatment of gallstones,but postoperative defecation dysfunction are common.The postoperative defecation dysfunction is significant correlation with postoperative gallbladder systolic function.