微创胆囊切除术治疗老年慢性胆囊炎伴胆囊结石的临床疗效及对炎症因子的影响

发布时间：2019-03-01 08:46

【摘要】：目的探讨微创胆囊切除术对老年慢性胆囊炎伴胆囊结石患者临床疗效与炎症因子的影响。方法选取60例老年慢性胆囊炎伴胆囊结石患者,将其运用随机数字表法分为微创组和开放组,每组30例。微创组运用微创胆囊切除术进行干预,开放组运用传统开放术进行干预,对比分析两种治疗方式对患者临床疗效与炎症因子的影响。结果与开放组相比,微创组手术持续时间、术后肠鸣音恢复时间、术后住院天数明显缩短(P=0.000;P=0.000;P=0.004),术中出血量、术后疼痛评分及术区感染明显减少(P=0.017;P=0.000;P=0.044);术后出血减少,但差异无统计学意义(P=0.076)。在治疗后1 d时,开放组白细胞介素(IL)-6、IL-8及C反应蛋白(CRP)水平高于微创组(P0.05),在治疗后3 d时,开放组IL-6、IL-8及CRP含量仍高于微创组(P0.05);在治疗后1 d时,开放组IL-2含量低于微创组(P0.05),在治疗后的3 d时,开放组IL-2含量仍低于微创组(P0.05)。结论微创胆囊切除术手术持续时间短、肠鸣音恢复时间快、住院时间短、术后并发症少,对血清中炎症因子几乎无影响,可以作为老年慢性胆囊炎伴胆囊结石患者的首选术式。
[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]
【作者单位】：浙江大学医学院附属第二医院外二病区;
【分类号】：R657.4

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