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短时间窗内腹腔镜胆囊切除术对急性胆囊炎患者肝功能、炎症反应及预后的影响分析
作者:沈晓峰  张进  张海  徐三荣 
单位:江苏大学附属医院 普外科, 江苏 镇江 212001
关键词:短时间窗 急性胆囊炎 腹腔镜胆囊切除术 肝功能 炎性反应 预后 
分类号:R459.9;R605
出版年·卷·期(页码):2019·38·第十一期(1414-1417)
摘要:

目的:探讨短时间窗内腹腔镜胆囊切除术(LC)对急性胆囊炎患者肝功能、炎症反应及预后的影响。方法:选取江苏大学附属医院收治的行LC的120例急性胆囊炎患者,根据手术时机的不同分为研究组和对照组,每组各60例。研究组在3 d内行LC,对照组在3 d后行LC,比较两组患者的疗效、肝功能、炎症反应及术后1个月预后情况等差异。结果:研究组患者的手术时间、术后首次下床活动时间、术后肛门排气时间、住院时间、住院费用及术后并发症发生率均显著少于或低于对照组(P<0.05);术中出血量方面两组差异无统计学意义(P>0.05);术前两组患者的肝功能及炎症反应相关指标比较差异均无统计学意义(P>0.05),而术后3 d研究组患者的肝功能及炎症反应相关指标均较对照组明显改善(P<0.05);术后1个月预后情况两组差异无统计学意义(P>0.05)。结论:短时间窗内LC治疗急性胆囊炎患者的疗效显著,同时可减轻对机体肝功能的损害并降低炎症反应程度,值得临床推广应用。

Objective: To investigate the effect of laparoscopic cholecystectomy in a short-time window on liver function, inflammatory response and prognosis in patients with acute cholecystitis. Methods: 120 patients with acute cholecystitis who were treated with laparoscopic cholecystectomy (LC) in the Affiliated Hospital of Jiangsu University were selected and they were randomly divided into study group and control group with 60 cases in each according to the time of the operation. The patients in the study group underwent LC surgery within 3 days, and the controls underwent LC surgery after 3 days. Then the differences in curative effects, liver function, inflammatory response, and prognosis in one month were compared between the two groups. Results: The numbers of operation time, activity time, exhaust time, hospital stay, hospital expenses, and complication rate in the study group were less than those in the control group (P<0.05), while there was no significant difference between the two groups in the amount of intraoperative blood loss (P>0.05).There were no statistically significant differences in liver function and inflammatory response related indexes between the two groups before surgery (P>0.05), while the liver function and inflammatory response related indexes of the study group were significantly improved compared with the control group on the 3rd day after operation (P<0.05).There was no significant difference in prognosis in 1 month after the operation between the two groups (P>0.05). Conclusion: Laparoscopic cholecystectomy in a short time window is obviously effective for patients with acute cholecystitis, which can reduce the damage to the liver function and the degree of inflammatory response. It is worthy of clinical popularization and application.

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