【摘要】：目的探討微創(chuàng)膽囊切除術對老年慢性膽囊炎伴膽囊結石患者臨床療效與炎癥因子的影響。方法選取60例老年慢性膽囊炎伴膽囊結石患者,將其運用隨機數(shù)字表法分為微創(chuàng)組和開放組,每組30例。微創(chuàng)組運用微創(chuàng)膽囊切除術進行干預,開放組運用傳統(tǒng)開放術進行干預,對比分析兩種治療方式對患者臨床療效與炎癥因子的影響。結果與開放組相比,微創(chuàng)組手術持續(xù)時間、術后腸鳴音恢復時間、術后住院天數(shù)明顯縮短(P=0.000;P=0.000;P=0.004),術中出血量、術后疼痛評分及術區(qū)感染明顯減少(P=0.017;P=0.000;P=0.044);術后出血減少,但差異無統(tǒng)計學意義(P=0.076)。在治療后1 d時,開放組白細胞介素(IL)-6、IL-8及C反應蛋白(CRP)水平高于微創(chuàng)組(P0.05),在治療后3 d時,開放組IL-6、IL-8及CRP含量仍高于微創(chuàng)組(P0.05);在治療后1 d時,開放組IL-2含量低于微創(chuàng)組(P0.05),在治療后的3 d時,開放組IL-2含量仍低于微創(chuàng)組(P0.05)。結論微創(chuàng)膽囊切除術手術持續(xù)時間短、腸鳴音恢復時間快、住院時間短、術后并發(fā)癥少,對血清中炎癥因子幾乎無影響,可以作為老年慢性膽囊炎伴膽囊結石患者的首選術式。
[Abstract]:Objective to investigate the effect of minimally invasive cholecystectomy on clinical efficacy and inflammatory factors in elderly patients with chronic cholecystitis with gallstone. Methods 60 elderly patients with chronic cholecystitis with gallstone were randomly divided into minimally invasive group (n = 30) and open group (n = 30). The minimally invasive cholecystectomy was used in the minimally invasive group and the traditional open cholecystectomy was used in the open group. The effects of the two treatment methods on the clinical efficacy and inflammatory factors were compared and analyzed. Results compared with open group, the duration of operation, the recovery time of intestinal sound and the days of hospitalization in minimally invasive group were significantly shorter than those in open group (P < 0.001). The amount of intraoperative bleeding, postoperative pain score and postoperative infection were significantly decreased (P < 0.017), but there was no significant difference between the two groups (P < 0.076), but there was no significant difference between the two groups (P < 0.05), but there was no significant difference between the two groups (P < 0.05). On the 1st day after treatment, the levels of interleukin-6 (IL-6), interleukin-8 (IL-8) and C-reactive protein (CRP) in the open group were higher than those in the minimally invasive group (P0.05). On the 3rd day after treatment, the IL-6, in the open group was higher than that The contents of IL-8 and CRP were still higher than those of minimally invasive group (P0.05). On the 1st day after treatment, the content of IL-2 in the open group was lower than that in the minimally invasive group (P0.05), and the content of IL-2 in the open group was still lower than that in the minimally invasive group on the 3rd day after treatment (P0.05). Conclusion minimally invasive cholecystectomy can be used as the first choice for elderly patients with chronic cholecystitis with cholelithiasis due to its short duration, fast recovery time, short hospitalization time, few postoperative complications and little effect on serum inflammatory factors. [WT5 "HZ] conclusion [WT5" BZ] [WT5 "BZ]
【作者單位】： 浙江大學醫(yī)學院附屬第二醫(yī)院外二病區(qū);
【分類號】：R657.4

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