微创保胆取石术前后胆囊结石患者胆囊收缩率、胆囊收缩素水平的变化

发布时间：2018-04-03 16:28

本文选题：胆囊结石　切入点：胆囊收缩率　出处：《现代中西医结合杂志》2016年34期

【摘要】：目的观察微创保胆取石术前后胆囊结石患者胆囊收缩率、胆囊收缩素水平的变化。方法将胆囊结石患者96例作为治疗组,采用腹腔镜、胆道镜双镜联合微创保胆取石术(LRCL)方法治疗,另选取健康职工50例,作为正常对照组。2组于术前行B超检查并计算胆囊最大收缩率以及血浆胆囊收缩素(CCK)水平比较;治疗组于术后3个月、12个月、24个月进行B超检查计算胆囊最大收缩率以及CCK检测;统计分析2组并发症发生情况及复发率。结果术前对照组胆囊最大收缩率高于试验组(P=0.000)。术前对照组空腹血浆CCK有低于试验组的趋势,但差异无统计学意义(P=0.316)。LRCL术后治疗组胆囊收缩功能渐进恢复,70%患者术后24个月胆囊功能恢复正常。术后CCK水平逐渐升高,经两两比较术后24个月CCK水平与治疗前以及术后3个月比较差异均有统计学意义(P=0.048,P=0.003)。所有患者无术中及术后并发症发生。术后胆囊结石复发4例,复发率4.1%,服用熊去胆酸治疗6个月后结石均消失。结论保胆取石术保留了胆囊的生理功能,可减少并发症,是治疗胆囊结石合理有效的方法之一,但术前空腹血浆CCK的检查不能作为是否行保胆手术的评估指标。
[Abstract]:Objective to observe the changes of gallbladder contraction rate and cholecystokinin level in patients with cholecystolithiasis before and after minimally invasive cholecystectomy.Methods 96 patients with cholecystolithiasis were treated by laparoscopy, choledochoscopy and minimally invasive cholecystolithotomy with LRCL.The other 50 healthy workers were selected.As the normal control group, B ultrasound was performed before operation to calculate the maximum contraction rate of gallbladder and the level of CCK in plasma cholecystokinin (CCK).In the treatment group, the maximum contraction rate of gallbladder and the detection of CCK were calculated by B-ultrasound at 3 months, 12 months and 24 months after operation, and the incidence and recurrence rate of complications were analyzed statistically.Results the maximal contraction rate of gallbladder in the control group was higher than that in the test group before operation.The fasting plasma CCK in the control group was lower than that in the experimental group, but there was no significant difference between the two groups. The gallbladder systolic function recovered gradually in 70% of the patients in the treatment group 24 months after operation.The level of CCK increased gradually after operation. The level of CCK in 24 months after operation was significantly higher than that before treatment and 3 months after operation.No intraoperative or postoperative complications occurred in all patients.The recurrence rate of cholecystolithiasis was 4.1. After 6 months of ursodecholic acid treatment, the stones disappeared.Conclusion Litholithotomy can preserve the physiological function of gallbladder and reduce complications. It is a reasonable and effective method to treat cholecystolithiasis, but fasting plasma CCK can not be used as an index to evaluate whether or not cholecystolithiasis is performed.
【作者单位】：河北北方学院附属第二医院;
【分类号】：R657.4

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