腹腔镜下胆总管切开取石一期缝合的应用效果研究OA
Study on the Application Effect of Laparoscopic Common Bile Duct Exploration with Primary Suture
目的:探讨腹腔镜下胆总管切开取石一期缝合的应用效果.方法:将2018年1月—2021年12 月苏州市相城人民医院的 80 例腹腔镜下胆总管切开取石患者根据随机数字表法分为对照组和试验组,各 40 例.对照组患者采用胆总管前壁间断缝合方法治疗,试验组患者采用一期连续缝合方法治疗.比较两组的治疗总有效率、术后并发症发生率、手术时间、手术前后生存质量评分、创伤应激反应指标[皮质醇(Cor)、白介素-6(IL-6)、C反应蛋白(CRP)及肿瘤坏死因子-α(TNF-α)]及胃肠激素[胃动素(MTL)、胃泌素(GAS)].结果:试验组的治疗总有效率明显高于对照组,手术时间明显短于对照组,术后并发症总发生率明显低于对照组,差异均有统计学意义(P<0.05).术前,两组的生存质量各维度评分、创伤应激反应指标及胃肠激素水平比较,差异均无统计学意义(P>0.05);术后 1 周,试验组的生存质量评分明显高于对照组,术后 1、2 d,试验组的创伤应激反应指标水平均明显低于对照组,胃肠激素指标水平均明显高于对照组,差异均有统计学意义(P<0.05).结论:腹腔镜下胆总管切开取石一期缝合的应用效果相对更好,且可有效控制患者的手术创伤应激反应,改善胃肠道功能、生存质量.
Objective:To investigate the application effect of laparoscopic common bile duct exploration with primary suture.Method:A total of 80 patients with laparoscopic common bile duct exploration in Suzhou Xiangcheng People's Hospital from January 2018 to December 2021 were divided into control group and experimental group according to the random number table,with 40 cases in each group.The control group were treated with intermittent suture of the anterior wall of the common bile duct,the experimental group were treated with primary continuous suture.The total response rate,postoperative complication rate,operative time,quality of life score,traumatic stress response indexes[cortisol(Cor),interleukin-6(IL-6),C reactive protein(CRP),tumor necrosis factor-α(TNF-α)]and gastrointestinal hormones[motilin(MTL),gastrin(GAS)]before and after operation were compared between the two groups.Result:The total effective rate of experimental group was significantly higher than that of control group,the surgical time was significantly shorter than that of control group,the total postoperative complications rate was significantly lower than that of control group,the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in the scores of quality of life,traumatic stress response indexes and gastrointestinal hormone levels between the two groups(P>0.05);1 week after surgery,the quality of life scores of experimental group were significantly higher than those of control group;1 and 2 d after surgery,the levels of traumatic stress response indexes of experimental group were significantly lower than those of control group,and the levels of gastrointestinal hormone indexes were significantly higher than those of control group,the differences were statistically significant(P<0.05).Conclusion:The application effect of laparoscopic common bile duct exploration with primary suture is relatively better,and it can effectively control the traumatic stress response and improve the gastrointestinal function and life quality of patients.
王凯;赵业剑;罗苏青
苏州市相城人民医院普外科 江苏 苏州 215000
腹腔镜下胆总管切开取石一期缝合创伤应激反应胃肠功能
Laparoscopic common bile duct explorationPrimary sutureTraumatic stress responseGastrointestinal function
《中国医学创新》 2024 (005)
5-9 / 5
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