胆囊后三角解剖入路腹腔镜手术对胆囊结石伴慢性胆囊炎患者的疗效分析

Curative Effect Analysis of Laparoscopic Surgery Through Posterior Triangular Anatomy of Gallbladder of Patients with Gallstones and Chronic Cholecystitis

目的探讨对胆囊结石伴慢性胆囊炎在腹腔镜手术中经胆囊后三角入路的临床效果。方法选择2020年5月—2023年5月本院收治的72例胆结石伴慢性胆囊炎患者为研究对象,所有患者均予腹腔镜胆囊切除术治疗,随机分为胆囊三角入路对照组(n=36)与胆囊后三角入路观察组(n=36),比较两组手术治疗术前术后疼痛(VAS)评分,检测治疗前后C反应蛋白(CRP)、白介素(IL)-6、IL-8评估炎症反应,另对比并发症情况。结果观察组手术时间、出血量、排气时间、排便时间、住院时间均优于对照组,组间差异有统计学意义(P<0.05)。观察组术后6h、12h、24h的VAS评分均低于对照组,组间差异有统计学意义(P<0.05)。术后观察组CRP、IL-6、IL-8低于对照组,组间差异有统计学意义(P<0.05)。观察组并发症率低于对照组,组间差异有统计学意义(P<0.05)。结论胆囊炎伴胆结石者腹腔镜下胆囊后三角入路治疗操作简单且损伤小,患者恢复快、疼痛轻微,能减轻炎症反应,降低并发症风险。

Objective To explore clinical effect of laparoscopic surgery for gallstones with chronic cholecystitis through posterior triangular approach of gallbladder.Methods The paper chose 72 patients with gallstones and chronic cholecystitis treated with laparoscopic cholecystectomy admitted to the hospital from May 2020 to May 2023,and divided them into control group(n=36)and observation group(n=36)randomly.Surgical treatment was compared,and preoperative and postoperative pain(VAS)scores were evaluated between two groups.C-reactive protein(CRP),interleukin-6(IL-6),and IL-8 was measured before and after treatment to evaluate the inflammatory response,incidence of complications was compared.Results Surgery time in observation group was(33.17±4.58)minutes,bleeding volume was(36.22±7.42)mL,exhaust time was(15.44±2.47)h,defecation time was(26.26±3.81)h,and hospital stay was(4.34±1.26)d,shorter and lower than control group respectively(P<0.05).The VAS scores were(4.21±1.15),(3.75±0.94),and(3.26±0.87)in observation group at 6h,12h,and 24h after surgery,lower than control group(P<0.05).The postoperative observation group had lower levels of CRP(11.82±1.95)mg/L,IL-6(22.45±4.72)ng/L,and IL-8(20.55±4.14)ng/L than control group(P<0.05).Incidence of complications in observation group was lower than control group(5.56%vs.22.22%,P<0.05).Conclusion Laparoscopic posterior gallbladder triangle approach is a simple and minimally invasive treatment for patients with cholecystitis and gallstones,with fast recovery and mild pain,which can alleviate inflammation and reduce the risk of complications.