急诊腹腔镜胆囊切除手术对急性胆囊炎患者的影响

Effect of Emergency Laparoscopic Cholecystectomy on Patients with Acute Cholecystitis

目的分析急诊腹腔镜胆囊切除手术(LC)对急性胆囊炎(AC)患者的影响。方法选取2022年11月—2023年11月本院收治的100例AC患者为研究对象,按随机数字表法将其分为对照组与观察组,各50例。对照组行开腹胆囊切除术,观察组行急诊LC。比较两组围术期指标、胃肠功能恢复情况、炎症因子水平、并发症发生情况。结果观察组术中出血量为(46.32±4.48)mL,少于对照组的(79.95±6.31)mL,手术时间为(62.21±3.69)min,住院时间为(7.45±1.21)d,首次排气时间为(1.25±0.18)d,术后进食时间为(2.16±0.32)d,均短于对照组的(78.63±4.28)min、(10.53±1.79)d、(2.41±0.39)d、(3.35±0.49)d,并发症发生率为4.00%,低于对照组的16.00%,组间差异有统计学意义(P<0.05)。观察组术后的白细胞介素-6为(218.95±16.35)pg/mL,C反应蛋白为(14.20±2.33)mg/L,肿瘤坏死因子-α为(32.35±3.84)ng/L,均低于对照组的(267.89±20.35)pg/mL、(16.74±2.88)mg/L、(39.83±4.24)ng/L,组间差异有统计学意义(P<0.05)。结论急诊LC具有创伤小、手术时间短等优势,引起的炎症反应更轻,有利于患者术后胃肠功能的迅速改善,且并发症少,有一定的应用价值,值得临床推广运用。

Objective To analyze the effect of emergency laparoscopic cholecystectomy(LC)on patients with acute cholecystitis(AC).Methods A total of 100 AC patients admitted to our hospital from November 2022 to November 2023 were selected as the research objects,and were divided into a control group and an observation group according to the random number table method,with 50 cases in each group.The control group underwent open cholecystectomy,and the observation group underwent emergency LC.The perioperative indicators,recovery of gastrointestinal function,levels of inflammatory factors and complications were compared between the two groups.Results The intraoperative blood loss of the observation group was(46.32±4.48)mL,which was less than(79.95±6.31)mL of the control group,the operation time was(62.21±3.69)min,the hospitalization time was(7.45±1.21)d,and the first exhaust time was(1.25±0.18)d,the postoperative eating time was(2.16±0.32)d,which were shorter than(78.63±4.28)min,(10.53±1.79)d,(2.41±0.39)d,(3.35±0.49)d in the control group,and the incidence of complications was 4.00%,which was lower than 16.00%in the control group,the differences between the two groups were statistically significant(P<0.05).In the observation group,the postoperative interleukin-6 was(218.95±16.35)pg/mL,C-reactive protein was(14.20±2.33)mg/L,tumor necrosis factor-αwas(32.35±3.84)ng/L,which were lower than(267.89±20.35)pg/mL,(16.74±2.88)mg/L,(39.83±4.24)ng/L in the control group,the differences between the two groups were statistically significant(P<0.05).Conclusion Emergency LC has the advantages of less trauma,shorter operation time,and lighter inflammatory reaction,which is conducive to the rapid improvement of gastrointestinal function after surgery,and has fewer complications.It has certain application value and is worthy of clinical application.