腹腔镜手术治疗胆囊结石中不同入路的应用效果对患者应激反应的影响研究

Effects of Different Approaches on Stress Response in Patients with Gallstones Treated by Laparoscopic Surgery

目的 研究腹腔镜手术治疗胆囊结石中不同入路的应用效果对应激反应的影响。方法 选取2020年2月—2022年8月涟水县人民医院收治的123例胆囊结石患者为研究对象,采用随机数表法分为对照组(n=61)与观察组(n=62)。对照组采用前三角入路手术,观察组采用后三角入路手术。比较两组患者的手术指标、应激反应指标、血清指标、术后疼痛感、术后并发症等。结果 观察组手术指标数据低于对照组,差异有统计学意义(P<0.05)。手术后,观察组SOD高于对照组,CRP、Cor、E水平低于对照组,差异有统计学意义(P<0.05)。手术后,观察组血清指标数据低于对照组,差异有统计学意义(P<0.05)。术后48 h,观察组疼痛感评分为(2.12±0.32)分,低于对照组的(3.05±0.57)分,差异有统计学意义(t=11.180,P<0.05)。观察组术后并发症发生率为0,低于对照组的9.84%,差异有统计学意义(χ^(2)=4.466,P=0.034)。结论 在针对胆囊结石进行腹腔镜手术治疗时,选择后三角入路手术能够获得更显著的效果,患者应激反应更低,胆管损伤程度更小,安全性更高。

Objective To investigate the effects of different laparoscopic approaches on stress response in the treatment of gallstones.Methods 123 patients with gallbladder stones admitted to the People's Hospital of Lianshui County from February 2020 to August 2022 were selected as the study subjects.They were randomly divided into a control group(n=61) and an observation group(n=62) using a random number table method.The control group underwent anterior triangular approach surgery,while the observation group underwent posterior triangular approach surgery.Compared the surgical indicators,stress response indicators,serum indicators,postoperative pain,and postoperative complications between the two groups of patients.Results The surgical index data of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).After operation,SOD in observation group was higher than that in the control group,the level of CRP,Cor,E were lower than those in the control group,the difference was statistically significant(P<0.05).After operation,the serum indexes of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).48 h after surgery,the pain score of the observation group was(2.12±0.32) points,lower than that of the control group(3.05±0.57) points,and the difference was statistically significant(t=11.180,P<0.05).The incidence of postoperative complications in the observation group was 0,which was lower than that in the control group(9.84%),and the difference was statistically significant(χ^(2)=4.466,P=0.034).Conclusion When laparoscopic surgery is performed for cholecystolithiasis,the posterior triangle approach can achieve more significant results,with lower stress response,less bile duct damage,and higher safety.