[1]邓明敏.胆囊切除术对胆囊结石患者胃肠功能及预后的影响[J].医学信息,2025,38(09):114-116,124.[doi:10.3969/j.issn.1006-1959.2025.09.022]
 DENG Mingmin.Effect of Cholecystectomy on Gastrointestinal Function and Prognosis in Patients with Gallstones[J].Journal of Medical Information,2025,38(09):114-116,124.[doi:10.3969/j.issn.1006-1959.2025.09.022]
点击复制

胆囊切除术对胆囊结石患者胃肠功能及预后的影响()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
38卷
期数:
2025年09期
页码:
114-116,124
栏目:
论著
出版日期:
2025-05-01

文章信息/Info

Title:
Effect of Cholecystectomy on Gastrointestinal Function and Prognosis in Patients with Gallstones
文章编号:
1006-1959(2025)09-0114-04
作者:
邓明敏
奉新县中医院外一科,江西 奉新 330700
Author(s):
DENG Mingmin
The First Department of Surgery, Fengxin County Hospital of Traditional Chinese Medicine, Fengxin 330700, Jiangxi, China
关键词:
胆囊切除术胆囊结石胃肠功能
Keywords:
Cholecystectomy Gallstones Gastrointestinal function
分类号:
R657.4
DOI:
10.3969/j.issn.1006-1959.2025.09.022
文献标志码:
A
摘要:
目的 分析胆囊切除术对胆囊结石患者胃肠功能及预后的影响。方法 选取2022年8月-2023年8月我院诊治的61例胆囊结石患者为研究对象,采用随机数字表法分为对照组(n=30)和观察组(n=31),对照组采用常规开腹胆囊切除术,观察组采用腹腔镜胆囊切除术,比较两组临床手术指标、胃肠功能指标[胃动素(MTL)、胃泌素(GAS)]、应激反应指标[内皮素(ET)、皮质醇(Cor)、超氧化物歧化酶(SOD)]、并发症发生率、复发率。结果 与对照组比较,观察组手术时间、首次排气时间及住院时间更短、术中出血量更少(P<0.05);两组术后MTL、GAS均低于术前,但与对照组比较,观察组术后MTL、GAS更高(P<0.05);与对照组比较,观察组术后ET、Cor更低,SOD更高(P<0.05);与对照组并发症发生率的16.67%,观察组并发症发生率更低,为6.45%(P<0.05);随访5个月,观察组复发率与对照组比较,差异无统计学意义(P>0.05)。结论 胆囊切除术可缩短手术时间、术后首次排气时间、住院时间,减少术中出血量,减轻应激反应,且对胃肠功能影响小,另可实现与开腹切除术基本相同的预后效果,值得临床应用。
Abstract:
Objective To analyze the effect of cholecystectomy on gastrointestinal function and prognosis in patients with gallstones. Methods A total of 61 patients with gallstones diagnosed and treated in our hospital from August 2022 to August 2023 were selected as the research objects. They were divided into control group (n=30) and observation group (n=31) by random number table method. The control group was treated with conventional open cholecystectomy, and the observation group was treated with laparoscopic cholecystectomy. The clinical operation indexes, gastrointestinal function indexes [motilin (MTL), gastrin (GAS)], stress response indexes [endothelin (ET), cortisol (Cor), superoxide dismutase (SOD)], complication rate and recurrence rate were compared between the two groups. Results Compared with the control group, the operation time, first exhaust time and hospitalization time of the observation group were shorter, and the intraoperative blood loss was less (P<0.05). After surgery, the levels of MTL and GAS in the two groups were lower than those before surgery, but compare with the control group, the levels of MTL and GAS in the observation group were higher (P<0.05). Compared with the control group, ET and Cor in the observation group were lower, and SOD was higher after surgery (P<0.05). Compared with 16.67% of the control group, the incidence of complications in the observation group was lower (6.45%) (P<0.05). After 5 months of follow-up, there was no significant difference in the recurrence rate between the observation group and the control group (P>0.05). Conclusion Cholecystectomy can shorten the operation time, postoperative first exhaust time, hospitalization time, reduce intraoperative blood loss, reduce stress response, and has little effect on gastrointestinal function. In addition, it can achieve the same prognosis as laparotomy, which is worthy of clinical application.

参考文献/References:

[1]杨亚林,徐志杰.腹腔镜胆囊切除术治疗急性结石性胆囊炎合并胆汁性腹膜炎的术后感染状况分析[J].临床肝胆病杂志,2017,33(1):98-101.[2]汪昱,徐建明,莫玲斐.急性结石性胆囊炎行腹腔镜胆囊切除术后并发症的危险因素分析及风险预测模型的建立[J].安徽医药,2022,26(10):2068-2071.[3]丁瑞利,王保富,陈之强,等.双镜联合保胆取石术与腹腔镜胆囊切除术治疗胆囊结石的近期疗效比较[J].安徽医学,2023,44(2):158-161.[4]景化忠.腹腔镜胆囊切除术联合腹腔镜下胆总管探查一期缝合术在急性胆囊炎合并胆囊结石胆总管结石患者疗效观察[J].山西医药杂志,2022,51(1):75-77.[5]方旭东,姚宁,姜朝晖,等.腹腔镜胆囊切除术治疗急性结石性胆囊炎的效果分析[J].腹腔镜外科杂志,2018,23(5):371-373.[6]薛寒.腹腔镜胆囊切除术对急性胆囊炎患者术后胃肠功能恢复及康复进程的影响[J].现代诊断与治疗,2018,29(9):1444-1445.[7]胡勇,高琦,张翔,等.经内镜逆行胰胆管造影联合取石术与腹腔镜胆囊切除术治疗胆管结石的效果[J].长春中医药大学学报,2023,39(10):1146-1149.[8]皮儒先,龙玉屏,樊惠菱,等.腹腔镜胆囊切除术治疗急性胆囊炎并发胆结石的安全性及预后评估[J].重庆医学,2018,47(2):198-199,202.[9]王巍,刘晓宇.微创保胆取石术对老年胆结石患者胃肠功能和生活质量的影响[J].中国老年学杂志,2018,38(20):79-81.[10]吴志强,王卫东,刘清波.腹腔镜与开腹胆囊切除术治疗急性结石性胆囊炎的临床疗效对比[J].实用医学杂志,2017,33(13):2173-2175.[11]麻忠武,俞海波,潘步建,等.经皮经肝十二指肠乳头肌球囊扩张联合腹腔镜胆囊切除术治疗胆总管结石合并胆囊结石[J].中华普通外科杂志,2018,33(8):645-648.[12]张长和,田野,曹晓飞,等.经胆囊颈横断腹腔镜胆囊次全切除在复杂性胆囊切除术中应用32例体会[J].中国实用外科杂志,2017,37(9):1045-1046.[13]徐东兵.腹腔镜胆囊切除术联合胆道镜经胆囊管取石术治疗胆总管结石的临床观察[J].江西医药,2020,55(9):1213-1215.[14]过一清,韦凯扬,廖嘉忠,等.腹腔镜下胆囊切除术联合钬激光治疗胆囊结石合并胆总管结石的疗效观察[J].现代消化及介入诊疗,2020,25(11):1490-1492.[15]杨国林,孔德林,赵登秋,等.老年人胆囊结石行腹腔镜胆囊切除术患者216例临床分析[J].中国综合临床,2018,34(5):446-448.[16]谢刚,岳雁鸿,韩波,等.腹腔镜胆囊切除术联合茵陈蒿汤对急性结石性胆囊炎患者炎性反应递质及血清淀粉酶水平的影响[J].世界中医药,2019,14(6):1556-1559.[17]尼加提·塔西甫拉提,地力木热提·艾买提,张新峰,等.胆囊结石合并胆总管结石的相关危险因素分析[J].中华普通外科杂志,2020,35(8):633-636.[18]尉鹏,夏清华,唐学虎,等.腹腔镜胆囊切除术治疗慢性胆囊炎伴胆囊结石的临床疗效及安全性分析[J].国际外科学杂志,2018,45(3):177-182.[19]吴卫国,程平,刘安成,等.腹腔镜胆囊切除术与传统开腹胆囊切除术治疗胆囊结石临床疗效比较[J].肝胆外科杂志,2013,21(6):457-458.[20]方剑,开喆,陈祝明.腹腔镜下胆囊切除术与小切口胆囊切除术治疗胆囊结石的疗效观察及其对免疫功能的影响[J].河北医学,2020,26(7):1062-1066.[21]李良标.早期腹腔镜胆囊切除术治疗急性结石性胆囊炎的回顾性研究[J].安徽医药,2019,23(6):1173-1175.

相似文献/References:

[1]任海滨.微创手术治疗胆囊结石合并胆总管结石的临床疗效分析[J].医学信息,2018,31(02):107.[doi:10.3969/j.issn.1006-1959.2018.02.038]
 REN Hai-bin.Clinical Analysis of Minimally Invasive Surgery for Cholecystolithiasis Complicated by Choledocholithiasis[J].Journal of Medical Information,2018,31(09):107.[doi:10.3969/j.issn.1006-1959.2018.02.038]
[2]何 迎.Bulldog夹在三孔法腹腔镜保胆取石术中的应用分析[J].医学信息,2018,31(06):174.[doi:10.3969/j.issn.1006-1959.2018.06.063]
 HE Ying.Application of Bulldog Clip in Three-hole Laparoscopic Cholelithiasis Extraction[J].Journal of Medical Information,2018,31(09):174.[doi:10.3969/j.issn.1006-1959.2018.06.063]
[3]杨文娟,罗豆豆,石益萌,等.胆囊结石与2型糖尿病的共病机制[J].医学信息,2018,31(20):27.[doi:10.3969/j.issn.1006-1959.2018.20.009]
 YANG Wen-juan,LUO Dou-dou,SHI Yi-meng,et al.The Comorbid Mechanism of Gallstones and Type 2 Diabetes Mellitus[J].Journal of Medical Information,2018,31(09):27.[doi:10.3969/j.issn.1006-1959.2018.20.009]
[4]徐康忠.腹腔镜下胆囊切除术治疗胆结石的应用研究[J].医学信息,2019,32(01):128.[doi:10.3969/j.issn.1006-1959.2019.01.039]
 XU Kang-zhong.Application of Laparoscopic Cholecystectomy in the Treatment of Gallstones[J].Journal of Medical Information,2019,32(09):128.[doi:10.3969/j.issn.1006-1959.2019.01.039]
[5]李爱国,黎经何,史政荣.胆管端-端吻合治疗腹腔镜下胆囊切除术中 胆道损伤的疗效[J].医学信息,2019,32(15):88.[doi:10.3969/j.issn.1006-1959.2019.15.027]
 LI Ai-guo,LI Jing-he,SHI Zheng-rong.Efficacy of Bile Duct End-to-end Anastomosis for Biliary Tract Injury during Laparoscopic Cholecystectomy[J].Journal of Medical Information,2019,32(09):88.[doi:10.3969/j.issn.1006-1959.2019.15.027]
[6]宋炳豹,胡楠木,赵 威,等.Mirizzi综合征的腔镜治疗体会[J].医学信息,2019,32(19):190.[doi:10.3969/j.issn.1006-1959.2019.19.065]
 SONG Bing-bao,HU Nan-mu,ZHAO Wei,et al.Endoscopic Treatment of Mirizzi Syndrome[J].Journal of Medical Information,2019,32(09):190.[doi:10.3969/j.issn.1006-1959.2019.19.065]
[7]赵 乐,刘 乐.ALMA喉罩和Supreme喉罩在腹腔镜胆囊切除术患者气道管理中的应用[J].医学信息,2019,32(20):77.[doi:10.3969/j.issn.1006-1959.2019.20.021]
 ZHAO Le,LIU Le.Application of ALMA Laryngeal Mask and Supreme Laryngeal Mask in Airway Management of Patients Undergoing Laparoscopic Cholecystectomy[J].Journal of Medical Information,2019,32(09):77.[doi:10.3969/j.issn.1006-1959.2019.20.021]
[8]向红铭,易尚辉,吕 媛,等.铁路系统职工胆囊结石患病情况及其危险因素分析[J].医学信息,2020,33(05):126.[doi:10.3969/j.issn.1006-1959.2020.05.040]
 XIANG Hong-ming,YI Shang-hui,Lyu Yuan,et al.Prevalence of Cholecystolithiasis and Its Risk Factors in Railway System Workers[J].Journal of Medical Information,2020,33(09):126.[doi:10.3969/j.issn.1006-1959.2020.05.040]
[9]李文波.黄色肉芽肿性胆囊炎影像诊断及手术治疗[J].医学信息,2020,33(06):53.[doi:10.3969/j.issn.1006-1959.2020.06.016]
 LI Wen-bo.Imaging Diagnosis and Surgical Treatment of Xanthogranulomatous Cholecystitis[J].Journal of Medical Information,2020,33(09):53.[doi:10.3969/j.issn.1006-1959.2020.06.016]
[10]黄冬琴,吴 蔓.腹腔镜联合十二指肠镜及胆道镜在胆囊结石合并胆总管结石治疗中的应用[J].医学信息,2020,33(07):113.[doi:10.3969/j.issn.1006-1959.2020.07.034]
 HUANG Dong-qin,WU Man.Application of Laparoscopy Combined with Duodenoscope and Choledochoscope in the Treatment of Gallstones and Common Bile Duct Stones[J].Journal of Medical Information,2020,33(09):113.[doi:10.3969/j.issn.1006-1959.2020.07.034]
[11]曾志华.腹腔镜辅助下胆总管探查术及胆囊切除术治疗胆囊结石合并胆总管结石的效果[J].医学信息,2023,36(20):141.[doi:10.3969/j.issn.1006-1959.2023.20.028]
 ZENG Zhi-hua.Effect of Laparoscopic Common Bile Duct Exploration and Laparoscopic Cholecystectomy in the Treatment of Cholecystolithiasis Complicated with Calculus of Common Bile Duct[J].Journal of Medical Information,2023,36(09):141.[doi:10.3969/j.issn.1006-1959.2023.20.028]

更新日期/Last Update: 1900-01-01