腹腔镜胆囊切除术治疗急性发作期胆囊炎的临床价值研究

Study on the Clinical Value of Laparoscopic Cholecystectomy for Acute Onset Cholecystitis

目的:研究腹腔镜胆囊切除术治疗急性发作期胆囊炎患者的临床价值。方法:选择2021年1月~2024年3月海安市李堡中心卫生院外科收治的急性发作期胆囊炎患者73例,按照随机数字表法分组,对照组(n=36)实施常规开腹手术治疗,观察组(n=37)实施腹腔镜胆囊切除术治疗,比较两组患者治疗前后各项临床症状评分、临床各项手术指标、治疗前后炎症因子水平[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-8(IL-8)、C反应蛋白(CRP)]、治疗前后肠屏障功能以及应激指标[二胺氧化酶(DAO)、D-乳酸、肠脂肪酸结合蛋白(IFABP)、肾上腺素、前列腺素E2]。结果:治疗前,两组患者的各项临床症状评分、炎症因子水平、肠屏障功能以及应激指标比较无统计学意义(P>0.05),治疗后,观察组患者的各项临床症状评分、炎症因子水平、肠屏障功能以及应激指标均优于对照组(P<0.05);观察组临床各项手术指标均优于对照组(P<0.05)。结论:急性发作期胆囊炎患者通过腹腔镜胆囊切除术进行治疗,可有效改善患者临床症状以及炎症因子,降低应激指标,临床价值高。

Objective:To study the clinical value of laparoscopic cholecystectomy in patients with acute-onset cholecystitis.Methods:73 patients with acute onset cholecystitis admitted to Department of Surgery of Hai’an Fort Lee Central Health Center from January 2021 to March 2024,grouaccording by random number table,the control group(n=36)performed routine laparotomy,observation group(n=37)underwent laparoscopic cholecystectomy,compare the clinical symptom scores before and after treatment between the two groups;Clinical surgical indicators;Inflammatory factor levels before and after treatment[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8),and C-reactive protein(CRP)];Bowel barrier function and stress indicators before and after treatment[diamine oxidase(DAO),D-lactate,intestinal fatty acid-binding protein(IFABP),adrenaline,prostaglandin E2].Results:Before treatment,the clinical symptom scores,inflammatory factor level,intestinal barrier function and stress indicators between the two groups(P>0.05),the clinical symptom scores,intestinal barrier function and stress indicators of the observation group were better than those of the control group(P<0.05);The observation group were better than the control group(P<0.05).Conclusion:Patients with acute cholecystitis undergoing laparoscopic cholecystectomy can effectively improve their clinical symptoms and inflammatory factors,reduce stress indicators,have high clinical value.