[1]孙 伟.腹腔镜胆囊切除术治疗结石性胆囊炎的临床效果观察[J].医学信息,2019,32(03):113-115.[doi:10.3969/j.issn.1006-1959.2019.03.035]
　SUN Wei.Clinical Observation of Laparoscopic Cholecystectomy for Calculus Cholecystitis[J].Journal of Medical Information,2019,32(03):113-115.[doi:10.3969/j.issn.1006-1959.2019.03.035]
点击复制

腹腔镜胆囊切除术治疗结石性胆囊炎的临床效果观察()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年03期
页码:
113-115
栏目:
临床研究
出版日期:
2019-02-01

文章信息/Info

Title:
Clinical Observation of Laparoscopic Cholecystectomy for Calculus Cholecystitis
文章编号:
1006-1959（2019）03-0113-03
作者:
孙 伟
（北京中医医院平谷医院普外科，北京 101200）
Author(s):
SUN Wei
(General Surgery,Pinggu Hospital,Beijing Hospital of Traditional Chinese Medicine,Beijing 101200,China)
关键词:
腹腔镜胆囊切除术; 结石性胆囊炎; 血清炎性因子; 免疫球蛋白
Keywords:
Laparoscopic cholecystectomy; Calculous cholecystitis; Serum inflammatory factor;  Immunoglobulin
分类号:
R657.4
DOI:
10.3969/j.issn.1006-1959.2019.03.035
文献标志码:
A
摘要:
目的 探讨腹腔镜胆囊切除术和传统开腹术治疗结石性胆囊炎疗效及对患者免疫功能影响。方法 选取我院2013年6月~2017年6月我院收治的结石性胆囊炎患者90例，根据随机数字表法分为观察组和对照组，每组45例。对照组采用传统开腹手术治疗，观察组采用腹腔镜胆囊切除术治疗，观察两组患者术中出血量、手术时间、胃肠功能恢复时间、住院时间、术后并发症情况，并比较两组患者血清炎性因子和免疫球蛋白水平。结果 观察组患者术中出血量、胃肠功能恢复时间、住院时间均少于对照组，差异有统计学意义（P＜0.05）。治疗后，两组患者血清炎性因子水平均上升，但观察组患者CRP、IL-6、TNF-α上升程度低于对照组（P＜0.05）；治疗后，两组患者免疫球蛋白水平均下降，但观察组患者IgA、IgG、IgM下降程度低于对照组，差异有统计学意义（P＜0.05）。观察组患者术后并发症发生率为4.44%，低于对照组的15.56%，差异有统计学意义（P＜0.05）。结论 相比于传统开腹手术，腹腔镜胆囊切除术可减少术中出血量，缩短结石性胆囊炎恢复时间和住院时间，对患者炎症反应、免疫功能影响较小，安全性较高。
Abstract:
Objective To investigate the effect of laparoscopic cholecystectomy and traditional laparotomy on calculus cholecystitis and its effect on immune function. Methods 90 patients with calculus cholecystitis admitted to our hospital from June 2013 to June 2017 were enrolled. According to the random number table method, they were divided into observation group and control group, with 45 cases in each group. The control group was treated with conventional open surgery. The observation group was treated with laparoscopic cholecystectomy. The intraoperative blood loss, operation time, gastrointestinal function recovery time, hospitalization time and postoperative complications were observed. Patients with serum inflammatory factors and immunoglobulin levels. Results The intraoperative blood loss, gastrointestinal function recovery time and hospitalization time were lower in the observation group than in the control group,the difference was statistically significant (P<0.05). After treatment, serum inflammatory factors increased in both groups, but the increase in CRP, IL-6, and TNF-α in the observation group was lower than that in the control group (P<0.05). After treatment, the immunoglobulin levels in the two groups were treated decreased, but the decrease of IgA, IgG and IgM in the observation group was lower than that in the control group,the difference was statistically significant (P<0.05). The incidence of postoperative complications in the observation group was 4.44%, which was lower than that in the control group 15.56%, the difference was statistically significant (P<0.05).Conclusion Compared with traditional open surgery, laparoscopic cholecystectomy can reduce intraoperative blood loss, shorten the recovery time and hospitalization time of calculous cholecystitis, and have less impact on patients' inflammatory response and immune function, and have higher safety.

参考文献/References:


[1]孟飞龙,杜冠杰,王登科,等.腹腔镜与开腹手术对急性胆囊炎的临床治疗效果分析[J].中国实用医药,2017,12(14):38-40.
[2]罗年安,陈玉宝.腹腔镜与开腹手术治疗结石性胆囊炎的临床对照研究[J].生物医学工程与临床,2017,21(2):179-182.
[3]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.
[4]桑畅野,王燕鹏.腹腔镜胆囊切除术治疗伴胆囊颈部结石嵌顿的急性胆囊炎的临床体会[J].医学研究杂志,2015,44(9):149-151.
[5]吐尔地·吐拉提.腹腔镜与传统开腹手术治疗急性结石性胆囊炎的疗效对比研究[J].医学信息,2015,28(30):94-95.
[6]钱友庆.腹腔镜手术治疗急性胆囊炎的应用价值[J].腹腔镜外科杂志,2016,21(2):141-144.
[7]翟荣幸,汪宏.腹腔镜与开腹胆囊切除术对急性结石性胆囊炎患者胃肠功能的影响[J].中国现代普通外科进展,2015,18(7):566-568.
[8]马青松,张云芬.急性胆囊炎患者手术前后血清炎性因子水平变化的临床意义[J].河北医药,2016,38(14):2167-2169.
[9]倪宏,李长江,项系青.腹腔镜胆囊切除术对机体炎症反应、氧化应激及细胞免疫功能的影响[J].海南医学院学报,2016,22(2):160-162.
[10]孙海光.腹腔镜手术治疗急性结石性胆囊炎的临床疗效分析[J].中外医疗,2017,36(17):95-97.

相似文献/References:

[1]尹增盛,李淑琴,崔 辉.不同压力二氧化碳气腹对老年腹腔镜胆囊切除术患者术后认知功能的影响[J].医学信息,2018,31(20):86.[doi:10.3969/j.issn.1006-1959.2018.20.024]
　YIN Zeng-sheng,LI Shu-qin,CUI Hui.Effect of Different Pressure Carbon Dioxide Pneumoperitoneum on Postoperative Cognitive Function in Elderly Patients Undergoing Laparoscopic Cholecystectomy[J].Journal of Medical Information,2018,31(03):86.[doi:10.3969/j.issn.1006-1959.2018.20.024]
[2]张德龙,孙昱慧,薛金晶.延迟腹腔镜胆囊切除术对老年结石性胆囊炎患者围术期指标及预后生存质量的影响[J].医学信息,2022,35(13):159.[doi:10.3969/j.issn.1006-1959.2022.13.039]
　ZHANG De-long,SUN Yu-hui,XUE Jin-jing.Effect of Delayed Laparoscopic Cholecystectomy on Perioperative Indexes and Prognosis Quality of Life in Elderly Patients with Calculous Cholecystitis[J].Journal of Medical Information,2022,35(03):159.[doi:10.3969/j.issn.1006-1959.2022.13.039]
[3]俞卫铿.腹腔镜胆囊切除术治疗胆囊结石伴慢性胆囊炎患者临床疗效[J].医学信息,2022,35(17):110.[doi:10.3969/j.issn.1006-1959.2022.17.029]
　YU Wei-keng.Clinical Effect of Laparoscopic Cholecystectomy in Treatment of Patients with Gallstone and Chronic Cholecystitiss[J].Journal of Medical Information,2022,35(03):110.[doi:10.3969/j.issn.1006-1959.2022.17.029]
[4]巴 琳,曾凡荣,郭忠宝.地塞米松联合切口阻滞和腹腔内局部麻醉对腹腔镜胆囊切除术后的镇痛效果[J].医学信息,2020,33(08):167.[doi:10.3969/j.issn.1006-1959.2020.08.056]
　BA Lin,ZENG Fan-rong,GUO Zhong-bao.Analgesic Effect of Dexamethasone Combined with Incision Block and Intraperitoneal Local Anesthesia After Laparoscopic Cholecystectomy[J].Journal of Medical Information,2020,33(03):167.[doi:10.3969/j.issn.1006-1959.2020.08.056]
[5]王跃振,梁 皓,田本祎,等.超声引导下腹横肌平面阻滞在老年腹腔镜胆囊切除术中的应用[J].医学信息,2021,34(07):122.[doi:10.3969/j.issn.1006-1959.2021.07.033]
　WANG Yue-zhen,LIANG Hao,TIAN Ben-yi,et al.Application of Ultrasound-guided Transversus Abdominis Plane Block in Elderly Laparoscopic Cholecystectomy[J].Journal of Medical Information,2021,34(03):122.[doi:10.3969/j.issn.1006-1959.2021.07.033]
[6]郭丽娜.“5E”护理模式在腹腔镜胆囊切除术后患者中的应用效果[J].医学信息,2023,36(02):160.[doi:10.3969/j.issn.1006-1959.2023.02.035]
　GUO Li-na.Application Effect of "5E" Nursing Mode in Patients After Laparoscopic Cholecystectomy[J].Journal of Medical Information,2023,36(03):160.[doi:10.3969/j.issn.1006-1959.2023.02.035]
[7]黄雪薇,尹 泓,赵 聪,等.区域神经阻滞在腹腔镜胆囊切除术后镇痛的应用[J].医学信息,2021,34(16):33.[doi:10.3969/j.issn.1006-1959.2021.16.009]
　HUANG Xue-wei,YIN Hong,ZHAO Cong,et al.Application of Regional Nerve Block in Analgesia After Laparoscopic Cholecystectomy[J].Journal of Medical Information,2021,34(03):33.[doi:10.3969/j.issn.1006-1959.2021.16.009]
[8]葛子豪,姚 康,童朝刚.困难腹腔镜胆囊切除术术前评估及风险预测模型构建[J].医学信息,2023,36(07):41.[doi:10.3969/j.issn.1006-1959.2023.07.008]
　GE Zi-hao,YAO Kang,TONG Chao-gang.Preoperative Evaluation and Risk Prediction Model Construction of Difficult Laparoscopic Cholecystectomy[J].Journal of Medical Information,2023,36(03):41.[doi:10.3969/j.issn.1006-1959.2023.07.008]
[9]杨 琼.手术室综合护理对腹腔镜胆囊切除术患者应激反应及预后的影响[J].医学信息,2023,36(08):166.[doi:10.3969/j.issn.1006-1959.2023.08.037]
　YANG Qiong.Effect of Comprehensive Nursing in the Operating Room on Stress Response and Prognosis of Patients Undergoing Laparoscopic Cholecystectomy[J].Journal of Medical Information,2023,36(03):166.[doi:10.3969/j.issn.1006-1959.2023.08.037]
[10]刘君玲,苗长丰.柴胡舒肝散联合平胃散对腹腔镜胆囊切除术后胃肠功能的影响[J].医学信息,2021,34(21):162.[doi:10.3969/j.issn.1006-1959.2021.21.046]
　LIU Jun-ling,MIAO Chang-feng.Effect of Chaihu Shugan Powder Combined with Pingwei Powder on Gastrointestinal Function After Laparoscopic Cholecystectomy[J].Journal of Medical Information,2021,34(03):162.[doi:10.3969/j.issn.1006-1959.2021.21.046]

更新日期/Last Update: 2019-02-25