腹腔镜与开腹胆总管切开取石术应激反应差异分析

目的比较两种手术术式应用于结石患者治疗时应激反应差异。方法选取胆总管结石患者80名,随机分为腹腔镜组和开腹组,每组40例,均接受胆囊切除术和胆总管切开取石术;应用SPSS 20.0软件包进行数据处理,术中出血量、手术时间、术后胃肠道功能恢复时间、术后住院时间、Cor、C-P、FT3水平等计量资料以(x珋±s)表示,采用t检验;不良反应发生率等计数资料采用χ2检验,P0.05为差异具有统计学意义。结果腹腔镜组患者术中出血量、肠道功能恢复时间和住院时间显著低于开腹组(t=12.019,t=6.757,t=10.343,P0.01)。腹腔镜组患者术后3 d内血清皮质醇(Cor)、C-肽(C-P)和游离三碘甲状腺原氨酸(FT3)水平显著优于开腹组(t=6.296,t=11.030,t=7.408,P0.01)。腹腔镜组患者术后并发症发生率显著低于开腹组(χ2=15.313,P0.01)。结论腹腔镜胆总管切开取石术术中损伤小、术后恢复快患者应激反应小并发症发生率低,具有临床应用价值。

Stress response after laparoscopic or open choledocholithotomy

Objective To compare the differences of stress response after two kinds of surgical treatment for patients with choledocholith . Methods 80 patients with common bile duct stones were randomly divided into a laparoscopic group ( 40 patients ) and an open group ( 40 ) .Patients in the open group received open cholecystectomy and choledocholithotomy , whereas laparoscopic cholecystectomy and choledocholithotomy were performed in the laparoscopic group .SPSS 20.0 software package was used for data analysis.Measurement data were represented as mean ±SD and examined by Student ’s t test.The data included intraoperative blood loss , operation time , recovery time of postoperative gastrointestinal function , postoperative hospital stay , C-P, FT3 and Cor level .Count data such as incidence of adverse reactions were examined by the Chi-square test.P<0.05 was considered significantly different . Results Intraoperative blood loss , recovery time of gastrointestinal function , and hospitalization time in the laparoscopic group were significantly lower than those in the open group (t=12.019, t=6.757, t=10.343 respectively, P<0.01). The levels of serum Cor , C-P and FT3 were significantly better in the laparoscopic group than in the open group 3 days after surgery (t=6.296, t=11.030, t=7.408 respectively, P<0.01).The postoperative complications of the laparoscopic group were significantly lower than those of the open group (χ2 =15.313, P<0.01 ). Conclusion Laparoscopic choledocholithotomy has merits of minimal injury , rapid postoperative recovery, less stress response, and low incidence of complications .