腹腔镜胆囊切除术患者术后胃肠道功能恢复情况观察

目的:研究腹腔镜胆囊切除术对患者术后胃肠道功能恢复情况的影响。方法:将2011年6月至2013年10月期间来我院进行胆囊切除术的患者随机分成两组,对照组和观察组各84例,对照组采用常规开腹胆囊切除术,观察组则采用腹腔镜胆囊切除术。术后比较两组患者间胃肠道功能(腹胀、食欲情况、呕吐、肠鸣音恢复时间、肛门排气时间、肛门排便时间)恢复情况差异。术前及术后第24、72小时,空腹采血比较两组患者间胃肠激素(血清胃动素、胃泌素、血管活性肠肽及生长抑素)差异。结果:观察组患者术后肠鸣音恢复时间、肛门排气时间及肛门排便时间均显著短于对照组,P<0.05;另外观察组患者腹胀、呕吐及食欲差的发生率亦显著低于对照组,P<0.05。术后观察组患者胃动素、胃泌素水平显著高于对照组,血管活性肠肽水平则显著低于对照组,P<0.05。结论:腹腔镜胆囊切除术与常规开腹胆囊切除术相比,对患者的胃肠道功能影响小,患者术后胃肠道功能恢复快。

Observation of the recovery of gastrointestinal function after laparoscopic cholecystectomy

Objective： Observe the influence of laparoscopic cholecystectomy for the recovery of gastrointestinal function. Methods： Patients who took cholecystectomy from July 2011 to October 2013 were randomly divided into control group（ open cholecystectomy treatment group） of 84 cases and observation group（ laparoscopic cholecystectomy treatment group） of 84 cases,then the gastrointestinal function such as bloating,loss of appetite,vomiting,recovery time of bowel sounds,flatus and anal defecation of two groups after cholecystectomy were compared. The gastrointestinal hormone levels of fasting bloos such as motilin,gastrin,vasoactive intestinal peptide and somatostatin of two groups at the 24 th and 72 nd hour before and after cholecystectomy were compared. Results： The recovery time of bowel sounds,flatus and anal defecation of observation group were all shorter than those of control group,and the incidence of bloating,loss of appetite,vomiting were all less than those of control group（ P 〈 0. 05）. After the operation,the serum levels of motilin and gastrin of observation group were higher than control group,and the serum level of vasoactive intestinal peptide was lower than control group（ P〈 0. 05）. Conclusion： Compared with conventional open cholecystectomy,laparoscopic cholecystectomy has a smaller tract on the function of the gastrointestinal,and patients will get a faster recovery of gastrointestinal function.