Abstract
Objective:To comparatively analyze the influence of laparoscopic and open cholecystectomy on elderly patients' post-operative stress response and fatigue syndrome,trying to offer objective proof for the superiority of laparoscopic cholecystectomy in curing the elderly patients with cholecystolithiasis. Methods: The researcher screened 40 elderly gallbladder calculi patients, and then divided them into 2 operation groups: laparoscopic cholecystectomy ( LC) group and open cholecystectomy (OC) group. Each group consisted of 20 patients. The day before the operation was marked T0 ,the first day after operation was T, ,the second day after operation T2 ,the third day after operation T3. T0 ,T1 ,T2 ,T3 were chosen as the observation points. Various indicators, both in pre-operation and post-operation, were examined, such as interleukin-6 ( IL-6 ) , interleukin-10 (IL-10), C-reactive protein (CRP), white blood cell ( WBC) ,cortisol and postoperative fatigue score,etc. The operation time,intraoperative blood loss,post-operation analgesic using rate, the post-operative fever time,and the hospital stay were compared and analyzed between the 2 groups. Results:In post-operation,there appeared the obvious IL-6 increase in the two groups. And the increase amounted to the peak in the T1. In the T, and T2 of post-operation, IL-6 densities in LC were lower than those of 0C;In post-operation, the IL-10 density of patients in two groups began to decline both starting from T,. IL-10 densities in LC were at the lowest level in the T2 while in OC they were at the lowest level in the T3. IL-10 density levels measured in the T2 and T3 in LC were significantly higher than those of OC; post-operative CRP levels in both groups reached their peaks in the T1. Meanwhile, in the different post-operative periods CRP density levels in OC were significantly higher than those of LC,besides in the T3 ,they were higher than pre-operative level;the WBC in LC increased in the T1 and T2 ,the level of T3 was similar with pre-operative level,post-operative WBC number in OC increased in the T1,T2 ,T3 and reached its peak in the T, ;In post-operation, cortisol densities of the patients in LC showed no obvious increase in the T1 ,T2 ,T3. The post-operative cortisol densities of the patients in LC did not obviously increase,the cortisol densities in OC increased in the T1 before they restored to the normal level in the T2, showing the significant differences from that of T0. In the T1 , cortisol densities of the LC were lower than those in OC; Post-operative fatigue levels of the two groups'patients both increased and they reached the peak in the T1. Compared between the two groups, the post-operative levels in OC were significantly higher than those of LC. Conclusions: In treatment of the elderly patients with cholecysto-lithiasis,compared with OC,LC can obviously reduce post-operative stress response and fatigue syndrome. The clinical value of LC is reliable and significant.关键词
胆囊切除术,腹腔镜/剖腹术/应激/术后疲劳综合征/对比研究Key words
Cholecystectomy, laparoscopic/ Laparotomy/ Stress/ Postoperative fatigue syndrome/ Comparative study分类
医药卫生
