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不同时机行腹腔镜胆囊切除术治疗轻中症胆源性胰腺炎的效果比较

Comparison of the therapeutic effects of laparoscopic cholecystectomy at different timings on mild to moderate biliary pancreatitis
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摘要 目的分析轻中症胆源性胰腺炎(BAP)患者不同时机行腹腔镜胆囊切除术(LC)的临床效果。方法队列研究。抽取2019年10月至2023年10月驻马店市中心医院收治的72例轻中症BAP患者,根据患者住院后手术时机纳入早期组(27例)和晚期组(45例)。比较两组围术期指标,比较两组手术前后肝功能[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)]、胰腺功能[血清淀粉酶(AMY)、脂肪酶(LPS)]、炎性因子[C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素6(IL-6)]水平,比较两组住院期间并发症发生率。结果早期组手术时间、住院时间少于晚期组(P<0.05)。术后7 d,两组ALT、AST、AMY、LPS、CRP、PCT、IL-6水平均低于术前,且早期组低于晚期组(P<0.05)。两组并发症发生率比较差异未见统计学意义(P>0.05)。结论早期LC治疗轻中症BAP可改善患者围术期指标,降低炎性因子水平,改善肝功能、胰腺功能,安全性良好。 ObjectiveTo analyze the effect of laparoscopic cholecystectomy(LC)at different timings in the treatment of mild to moderate biliary pancreatitis(BAP).MethodsSeventy-two patients with mild to moderate BAP admitted to Zhumadian Central Hospital from October 2019 to October 2023 were selected for the cohort study.According to the surgery time after hospitalization,the selected patients were allocated in to the early group(27 cases)and the late group(45 cases).The perioperative indicators of the two groups were compared;the levels of liver function assessed by alanine transaminase(ALT)and aspartate aminotransferase(AST),pancreatic function assessed by serum amylase(AMY)and lipase(LPS),levels of inflammatory factors including C-reactive protein(CRP),procalcitonin(PCT)and interleukin-6(IL-6)were compared between the two groups before and after surgery.And the incidences of complications during hospitalization of the two groups were compared.ResultsThe surgery duration and hospital stay in the early group were less than those in the late group(P<0.05).After 7 days of surgery,the levels of ALT,AST,AMY,LPS,CRP,PCT,and IL-6 in both groups were lower than those before surgery,and the above indexes in the early group were lower than those in the late group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).ConclusionsEarly LC for mild to moderate BAP can improve perioperative indicators,reduce levels of inflammatory factors,and improve liver and pancreatic function,with good safety.
作者 翁昆仑 张鹏 张华甫 Weng Kunlun;Zhang Peng;Zhang Huafu(Department of Emergency,Zhumadian Central Hospital,Zhumadian 463000,China;Department of Hepatobiliary SurgeryⅡ,Zhumadian Central Hospital,Zhumadian 463000,China)
出处 《中国实用医刊》 2024年第19期27-30,共4页 Chinese Journal of Practical Medicine
关键词 胰腺炎 腹腔镜 胆囊切除术 治疗时机 围术期指标 炎性因子 Pancreatitis Laparoscopy Cholecystectomy Treatment timing Perioperative indexes Inflammatory factors
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