早期腹腔镜手术治疗胆源性急性胰腺炎的疗效探究

目的探讨早期腹腔镜手术治疗胆源性急性胰腺炎的疗效、安全性及应激反应程度。 方法分析2013年10月至2017年4月92例胆源性急性胰腺炎患者资料，随机分为早期组(早期腹腔镜手术，46例)和延期组(延期腹腔镜手术，46例)。应用统计学软件SPSS22.0分析，手术相关指标、皮质醇、肾上腺素水平数据用( ±s)来表示，组内治疗前后比较采用配对t检验，组间比较采用独立t检验；治疗总有效率、并发症发生率及复发率组间的比较采用χ²检验；P<0.05为差异有统计学意义。 结果早期组患者术中出血量、手术时间、住院时间、术后恢复时间均低于延期组(均P<0.05)。早期组治疗总有效率为93.48%(43/46)，延期组为89.13%(41/46)；两组并发症发生率、1年复发率差异均无统计学意义(P>0.05)；两组患者治疗后皮质醇、肾上腺素水平均高于治疗前(均P<0.05)，但早期组应激反应程度低于延期组(P<0.05)。 结论早期腹腔镜手术治疗胆源性急性胰腺炎的手术时间较短，术中出血量少，患者应激反应程度低，治疗效果优于延期腹腔镜手术，值得推广应用。

Efficacy of early laparoscopic surgery for the treatment of gallstone-induced acute pancreatitis

ObjectiveTo evaluate the efficacy, safety and stress response of early laparoscopic surgery for biliary acute pancreatitis. MethodsThe data of 92 cases of biliary acute pancreatitis from October 2013 to April 2017 were analyzed and randomly divided into early group (early laparoscopic surgery, 46 cases) and delayed group (delayed laparoscopic surgery, 46 cases). SPSS22.0 was used for analysis, the data of operative index, cortisol and epinephrine were expressed by ( ±s). The paired t test was used before and after the treatment in the group, and the independent sample t test was used between the groups. The total effective rate, the incidence of complications and the recurrence rate were compared with chi-square test. P<0.05 was statistical significance for differences. ResultsThe intraoperative blood loss, operative time, hospital stay and postoperative recovery time in the e arly group were lower than those in the delayed group (P<0.05). The total effective rate of treatment in the early group was 93.48% (43/46), and the delayed group was 89.13% (41/46). There was no significant difference in the incidence of complications and 1 year recurrence rate between the two groups (P>0.05). The levels of cortisol and epinephrine were higher than those before the treatment in the two groups (all P<0.05), but the degree of stress reaction in the early group was lower than that of the delayed group(P<0.05). ConclusionEarly laparoscopic surgery for biliary acute pancreatitis has a shorter operative time, less intraoperative blood loss, and a low degree of stress response. The treatment effect is better than delayed laparoscopic surgery and it is worthy of popularization and application.