腹腔镜胆囊切除术治疗对胆结石患者应激反应指标、胃肠激素水平的影响

Effect of Laparoscopic Cholecystectomy on Stress Response Indicators and Gastrointestinal Hormone Levels in Patients with Gallstones

目的探讨腹腔镜胆囊切除术治疗对胆结石患者应激反应指标、胃肠激素水平的影响。方法选择2022年10月—2023年10月金乡县人民医院收治的120例胆结石患者为研究对象,以随机数字表法将其分为对照组与观察组,各60例。对照组采用开腹胆囊切除术,观察组采用腹腔镜胆囊切除术。比较两组的围术期指标、应激反应指标、胃肠激素水平、术后并发症发生情况。结果观察组手术时间、术后首次排气时间、术后首次下床时间及住院时间均比对照组短,组间差异有统计学意义(P<0.05)。术后3 d,两组白细胞计数(WBC)、空腹血糖(FBG)、皮质醇(Cor)水平均较术前升高,但观察组WBC、FBG、Cor水平均比对照组低,差异有统计学意义(P<0.05);两组胃泌素、胃动素水平均较术前改善,且观察组胃泌素水平比对照组低,胃动素水平比对照组高,差异有统计学意义(P<0.05)。观察组术后并发症发生率为5.00%,低于对照组的16.67%,差异有统计学意义(P<0.05)。结论胆结石患者给予腹腔镜胆囊切除术治疗可使围术期指标及应激反应指标水平降低,改善胃肠激素水平,可减少并发症的发生。

Objective To explore the effects of laparoscopic cholecystectomy on stress response indicators and gastrointestinal hormone levels in patients with gallstones.Methods A total of 120 patients with gallstones from Jinxiang County People's Hospital from October 2022 to October 2023 were selected as the research objects and randomly divided into a control group and an observation group using a random number table method,with 60 patients in each group.The control group underwent open cholecystectomy,while the observation group underwent laparoscopic cholecystectomy.Compare perioperative indicators,stress response indicators,gastrointestinal hormone levels,and postoperative complications between two groups.Results The observation group had shorter surgical time,first postoperative exhaust time,first postoperative time getting out of bed,and hospitalization time compared to the control group,and the differences between the groups were statistically significant(P<0.05).Three days after surgery,the white blood cell count(WBC),fasting blood glucose(FBG),and cortisol(Cor)levels in both groups increased compared to preoperative levels,but the WBC,FBG,and Cor levels in the observation group were lower than those in the control group,with statistical significance(P<0.05);the levels of gastrin and motilin in both groups improved on average compared to preoperative levels,and the observation group had lower levels of gastrin and higher levels of motilin than the control group,with statistical significance(P<0.05).The incidence of postoperative complications in the observation group was 5.00%,which was lower than 16.67%in the control group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic cholecystectomy for patients with gallstones can reduce perioperative indicators and stress response indicators levels,improve gastrointestinal hormone levels,and reduce the incidence of complications.