免气腹腹腔镜胆囊切除术治疗急性结石性胆囊炎的临床效果及对炎症因子水平的影响

【目的】探讨免气腹腹腔镜胆囊切除术治疗急性结石性胆囊炎的临床效果及对炎症因子水平的影响。【方法】选取2018年7月至2019年5月本院收治的100例急性结石性胆囊炎患者,所有患者均行腹腔镜胆囊切除术,采用随机数表法将其分为观察组和对照组,每组各50例。对照组给予传统腹腔镜胆囊切除术,观察组给予免气腹腹腔镜胆囊切除术。比较两组患者手术时间、术中出血量、肛门首次排气时间、住院时间,并比较两组患者血清白细胞介素-1(IL-1)、白细胞介素-2(IL-2)和肿瘤坏死因子-α(TNF-α)水平。【结果】观察组术中出血量、肛门首次排气时间、住院天数与对照组比较,差异无统计学意义(P>0.05)。术前,两组患者血清IL-2、IL-1、TNF-α水平比较,差异无统计学意义(P>0.05);术后24 h,观察组血清IL-2水平高于对照组,IL-1、TNF-α水平低于对照组,差异有统计学意义(P<0.05)。观察组患者手术满意度评分为(9.21±0.38)分,高于对照组的(8.33±0.29)分,差异有统计学意义(t=13.017,P<0.05)。观察组术后肩背痛、切口感染、皮下气肿的发生率低于对照组,差异均有统计学意义(P<0.05)。【结论】免气腹腹腔镜胆囊切除术具有安全、有效,对机体应激反应影响较小的优点,患者满意度高,值得临床推广应用。

Clinical Effect of Pneumoperitoneum Laparoscopic Cholecystectomy in Treatment of Acute Calculous Cholecystitis and Influence on Level of Inflammatory Factors

【Objective】To explore the clinical effect of pneumoperitoneum laparoscopic:cholecystectomy in the treatment of acute calculous cholecystitis and its influence on the level of inflammatory factors.【Methods】A total of 100 patients undergoing abdominal Cholecystectomy with general anesthesia in Fengcheng Hospital of Fengxian District,Shanghai(July 2018 to May 2019)were randomly divided into two groups^with 50 cases each.Patients in the control group received traditional laparoscopic cholecystectomy,while the observation group was given pneumoperitoneum laparoscopic cholecystectomy.The operation time,intraoperative blood loss,the time of first anus exhaust,and hospitalization time were compared between the two groups of patients;and the serum levels of interleukin-1(IL-1),interleukin-2(IL-2)and tumor necrosis factor-α(TNF-α)of the two groups were compared as well.【Results】All patients had successful surgery,and there were no cases of the operation mode switch.In the observation group,the bleeding volume(19.15±5.28)mL,anal recovery exhaust time(14.59±4.69)h,hospital ization days(2.96±1.41)d,total hospitalization cost(4495.63±158.45)yuan were not statistically significant difference from the control group(P>0,05).There was no significant difference in the level of inflammatory factors between the two groups before operation(P>0.05).At 24 hours after operation,the levels of IL-2(IL-2)in the observation group were higher than that in the control group,while the levels of IL-1(IL-1)and tumor necrosis factor-α(TNF-α)in the observation group were lower than those in the control group(P<0.05).The incidence of shoulder and back pain(18.00%)and incision infection(0.00%)in the observation group was lower than that in the control group(38.00%and 8.00%);and the incidence of subcutaneous emphysema(0.00%)was not significantly different from tliat in the control group(6.00%,P>0.05).The score of satisfaction in the observation group(9.21±0.38)was higher than that in the control group(P<0.05).【Conclusion】Pneumoperitoneal laparoscopic cholecystectomy is safe,effective-less responsive to stress and high patient satisfaction.