一期腔镜手术治疗急性复杂性胆囊炎的临床疗效及对机体氧化应激反应的影响

目的:探讨一期腔镜手术治疗急性复杂性胆囊炎的临床疗效及对机体氧化应激反应的影响。方法:回顾分析2017年5月至2018年5月收治的82例急性复杂性胆囊炎患者的临床资料。根据手术方式分为研究组(n=40)与对照组(n=42),研究组行腹腔镜胆囊次全切除术,对照组行传统开放手术。观察比较两组手术指标、临床疗效、术后并发症及机体氧化应激反应指标水平。结果:研究组手术时间、术后排气时间、住院时间、术中出血量、总有效率优于对照组(97.5%vs.83.3%),差异有统计学意义(P<0.05);研究组术后并发症总发生率低于对照组(2.5%vs.19.0%),差异有统计学意义(P<0.05)。术前两组血清丙二醛、超氧化物歧化酶水平差异无统计学意义(P>0.05),术后即刻,研究组血清丙二醛水平高于对照组(P<0.05),超氧化物歧化酶水平低于对照组(P<0.05);术后24 h,研究组血清丙二醛水平低于对照组(P<0.05),超氧化物歧化酶水平高于对照组(P<0.05)。结论:一期腔镜手术治疗急性复杂性胆囊炎具有术后康复快、并发症少、有效率高等优势,且患者氧化应激指标水平恢复速度明显快于传统开放手术,值得推广应用。

Clinical efficacy of one-stage endoscopic cholecystectomy in the treatment of acute complex cholecystitis and its effect on oxidative stress

Objective:To investigate the clinical efficacy of one-stage endoscopic cholecystectomy in the treatment of acute complex cholecystitis and its effect on oxidative stress.Methods:The clinical data of 82 patients with acute complex cholecystitis admitted from May 2017 to May 2018 were analyzed retrospectively.According to the different surgical methods,the patients were divided into study group(40 cases)and control group(42 cases).The study group was treated with laparoscopic subtotal cholecystectomy,while the control group was treated with traditional open surgery.The operative indexes,clinical efficacy,postoperative complications and oxidative stress indexes were observed and compared between the two groups.Results:The operation time,postoperative exhaust time and hospitalization time of the study group were significantly shorter than those of the control group,and the intraoperative blood loss was significantly lower than that of the control group(P<0.05).The total effective rate of the study group was significantly higher than that of the control group(97.5%vs.83.3%,P<0.05).The total incidence of postoperative complications in the study group was significantly lower than that in the control group(2.5%vs.19.0%,P<0.05).There was no significant difference in malondialdehyde(MDA)and superoxide dismutase(SOD)levels between the two groups before surgery(P>0.05),and the MDA level of the study group immediately after operation was significantly higher than that of the control group(P<0.05),and the SOD level was significantly lower than that of the control group(P<0.05).24 h after surgery the MDA level of the study group was significantly lower than that of the control group(P<0.05),and SOD level of study group was significantly higher than that of the control group(P<0.05).Conclusions:One-stage laparoscopic cholecystectomy has the advantages of faster recovery,fewer complications and higher efficiency in the treatment of acute complex cholecystitis,and the recovery rate of oxidative stress index in patients undergoing laparoscopic surgery is significantly higher than that in patients with traditional open surgery,therefore the one-stage laparoscopic cholecystectomy is worth popularizing and applying.