摘要
目的:探讨胆总管结石合并胆管炎患者腹腔镜术后应激反应指标与恢复质量的相关性。方法:回顾性纳入2021年7月—2025年3月蚌埠医科大学第二附属医院收治的103例择期行腹腔镜胆总管切开取石术患者,依据入院时有无胆管炎分为无胆管炎组(n=52)与胆管炎组(n=51)。检测应激反应指标IL-6、hs-CRP、血糖波动值、正常窦性心搏RR间期标准差(SDNN)及气腹时间,评估以上指标与早期恢复指标、功能恢复质量的相关性。结果:胆管炎组术后24 h的IL-6、hs-CRP显著高于无胆管炎组,术后6 h血糖波动值大于无胆管炎组,术后6 h SDNN小于无胆管炎组(P<0.05)。相较无胆管炎组,胆管炎组首次排气时间晚,住院天数长,胆漏发生率及术后3 d VAS评分高,术后1周健康调查简表-8(SF-8)各维度评分低(P<0.05)。IL-6、hs-CRP、血糖波动值、气腹时间与首次排气时间、住院天数及VAS评分呈正相关,与SF-8呈负相关(P<0.001);SDNN与首次排气时间、住院天数及VAS评分呈负相关,与SF-8呈正相关(P<0.001)。结论:胆总管结石合并胆管炎患者腹腔镜术后IL-6和hs-CRP等应激反应指标与术后恢复质量具有相关性。
Objective:To investigate the correlation between the stress response indicators and recovery quality in patients with choledocholithiasis complicated with cholangitis after laparoscopic surgery.Method:A total of 103 patients who underwent elective laparoscopic choledocholithotomy and were admitted to the Second Affiliated Hospital of Bengbu Medical University from July 2021 to March 2025 were retrospectively included.They were divided into the non-cholangitis group(n=52)and the cholangitis group(n=51)based on whether there was cholangitis at admission.The stress response indicators IL-6,hs-CRP,blood glucose fluctuation value,standard deviation of NN intervals(SDNN),and pneumoperitoneum time were detected,and the correlations between the above indicators and the early recovery indicators and functional recovery were evaluated.Result:The IL-6 and hs-CRP levels in the cholangitis group at 24 h after surgery were significantly higher than those in the non-cholangitis group,the blood glucose fluctuation value at 6 h after surgery was greater than that in the non-cholangitis group,and the SDNN at 6 h after surgery was lower than that in the cholangitis group(P<0.05).Compared with the noncholangitis group,the first exhaust time of cholangitis group was later,the hospital stay was longer,the incidence of bile leakage and VAS score at 3 d after surgery were higher,and the score of each dimension of short form-8(SF-8)at 1 week after surgery were lower(P<0.05).IL-6,hs-CRP,blood glucose fluctuation value,pneumoperitoneum time were positively correlated with the first exhaust time,hospital stay and VAS scores,and were negatively correlated with SF-8(P<0.001).The SDNN was negatively correlated with the first exhaust time,hospital stay and VAS scores,and were positively correlated with SF-8(P<0.001).Conclusion:The stress response indicators such as IL-6 and hs-CRP in patients with choledocholithiasis complicated with cholangitis after laparoscopic surgery are correlated with the postoperative recovery quality.
作者
姚超
李乃树
陈正民
孙发缔
许兆龙
褚亮
YAO Chao;LI Naishu;CHEN Zhengmin;SUN Fadi;XU Zhaolong;CHU Liang(Department of General Surgery,the Second Affiliated Hospital of Bengbu Medical University,Bengbu 233000,China;不详)
出处
《中国医学创新》
2025年第28期145-150,共6页
Medical Innovation of China
关键词
胆总管结石
胆管炎
腹腔镜手术
应激反应
白介素-6
术后恢复
Choledocholithiasis
Cholangitis
Laparoscopic surgery
Stress response
Interleukin-6
Postoperative recovery
