摘要
目的探讨腔镜下行胆囊结石切除术的应用效果,以及其对患者胃肠功能及激素分泌恢复的影响。方法选取2017年5月至2018年12月在该院行胆囊结石切除术患者90例,采用随机数字表法将患者分为2组,各45例。对照组采用开腹胆囊切除术治疗,观察组采用腔镜下胆囊切除术治疗。比较2组患者治疗后胃肠功能恢复、胃肠激素分泌(胃动素、胃泌素)及血清炎症因子(肿瘤坏死因子-α、白细胞介素6、C反应蛋白)变化。结果术后,观察组患者的肠鸣音恢复时间、排气时间、排便时间均短于对照组,差异有统计学意义(P<0.05)。2组患者胃动素、胃泌素分泌水平均下降,且观察组上述各指标均低于对照组,差异有统计学意义(P<0.05)。2组患者的肿瘤坏死因子-α、白细胞介素6、C反应蛋白表达水平均升高,但观察组上述各指标均低于对照组,差异有统计学意义(P<0.05)。2组患者均出现切口感染、腹腔积液、胆管出血等并发症,但观察组并发症总发生率(6.67%)明显低于对照组(22.22%),差异有统计学意义(P<0.05)。结论腔镜下行胆囊结石切除术对患者胃肠功能损伤小,促进患者胃肠功能恢复,改善患者炎症因子水平,减少并发症的发生。
Objective To investigate the effect of laparoscopic cholecystectomy on the recovery of hormone secretion and gastrointestinal function.Methods A total of 90 patients with cholecystolithiasis underwent cholecystectomy from May 2017 to December 2018 were selected,and randomly divided into two groups,45 patients in each group.The control group was treated with open cholecystectomy,while the observation group was treated with cholecystectomy under endoscopy.The recovery of gastrointestinal function,gastrointestinal hormone secretion(motilin,gastrin)and serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)]were compared between the two groups after treatment.Results After operation,the recovery time of bowel sounds,exhaust time and defecation time in the observation group were shorter than those in the control group,the differences were statistically significant(P<0.05).The secretion levels of motilin and gastrin in both groups were decreased,and the above indexes in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The expression levels of TNF-α,IL-6 and CRP in both groups were increased,but the above indexes in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The incision infection,peritoneal effusion and bile duct hemorrhage occurred in both groups,but the total incidence of complications in the observation group(6.67%)was lower than that in the control group(22.22%),the difference was statistically significant(P<0.05).Conclusion Endoscopic cholecystectomy has less damage to gastrointestinal function,promotes the recovery of gastrointestinal function,improves the level of inflammatory factors,and reduces adverse reactions.
作者
刘众军
LIU Zhongjun(Zhoukou City Hospital of Traditional Chinese Medicine,Zhoukou,Henan 466000,China)
出处
《现代医药卫生》
2020年第12期1824-1826,共3页
Journal of Modern Medicine & Health
关键词
腔镜
胆囊切除术
胃肠功能
胃肠激素
炎症因子
Endoscopy
Cholecystectomy
Gastrointestinal function
Gastrointestinal hormone
Inflammatory factors
