不同胆囊入路腹腔镜胆囊切除术治疗胆囊结石合并慢性胆囊炎患者疗效

Efficacy of laparoscopic cholecystectomy with different gallbladder approaches in the treatment of patients with gallstones and chronic cholecystitis

目的:探究不同胆囊入路腹腔镜胆囊切除术对胆囊结石合并慢性胆囊炎患者的疗效.方法:选取2021年1月1日至2023年1月31日在本院治疗的胆囊结石伴慢性胆囊炎患者98例作为研究对象,采用随机抽签法分为对照组和实验组,每组各49例.对照组采用胆囊前三角解剖入路,实验组采用胆囊后三角解剖入路,分析比较两组的手术相关指标、炎性因子和免疫功能.结果:与对照组相比,实验组的手术时间、术中出血量、胃肠功能恢复时间,住院时间均显著降低(P<0.05).术后3 d,两组研究对象的白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-8(Interleukin-8,IL-8)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、C-反应蛋白(C-reactive protein,CRP)水平均显著降低,且实验组比对照组降低得更为显著(P<0.05).术后3 d,两组的血清CD4+和CD8+水平均显著降低,但实验组降低的幅度显著低于对照组(P<0.05).结论:采用后三角解剖入路行腹腔镜胆囊切除术治疗胆囊结石合并慢性胆囊炎,能降低患者外科创伤程度,缩短康复时间,减轻机体的炎症反应.

Objective:To explore the therapeutic effect of laparoscopic cholecystectomy with different gallbladder approaches on patients with gallstones and chronic cholecystitis.Method:A total of 98 patients with gallstones and chronic cholecystitis treated in our hospital from January 1,2021 to January 31,2023 were selected as the study subjects.They were randomly divided into a control group and an experimental group,with 49 cases in each group.The control group used the anterior gallbladder trigone anatomical approach,while the experimental group used the posterior gallbladder trigone anatomical approach.The surgical related indicators,inflammatory factors,and immune function of the two groups were analyzed and compared.Result:Compared with the control group,the experimental group had significantly reduced surgical time,intraoperative bleeding,gastrointestinal function recovery time,and hospital stay(P<0.05).Three days after surgery,the levels of interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),and C-reactive protein(CRP)were significantly reduced,and the experimental group showed a more significant decrease than the control group(P<0.05).After 3 days of surgery,the serum CD4+and CD8+levels in both groups were significantly reduced,but the magnitude of the decrease in the experimental group was significantly lower than that in the control group(P<0.05).Conclusion:Laparoscopic cholecystectomy using the posterior triangular anatomical approach for the treatment of gallstones combined with chronic cholecystitis can reduce the degree of surgical trauma,shorten recovery time,and alleviate the body's inflammatory response.