摘要
目的探究腹腔镜联合胆道镜手术对胆囊结石合并胆总管结石患者术后康复效果及应激反应的影响.方法选择2019年1月—2021年12月于本院普外科接受诊治的50例胆囊结石合并胆总管结石患者为研究对象,按手术方案不同分成两组,各25例.对照组采用开腹手术治疗,研究组采用腹腔镜联合胆道镜手术治疗.对比两组术后康复效果、手术前后应激反应变化、术后并发症发生率.结果研究组患者术后首次排气时间、首次排便时间、疼痛持续时间、下床活动时间及住院时间均短于对照组,组间差异有统计学意义(P<0.05).术后3 d,两组血浆醛固酮(ALD)、肾素活性(PRA)、血管紧张素Ⅱ(Ang-Ⅱ)水平均高于同组术前,但研究组血浆ALD、PRA、Ang-Ⅱ水平均低于对照组,组间差异有统计学意义(P<0.05).两组术后并发症发生率对比,差异无统计学意义(P>0.05).结论腹腔镜联合胆道镜手术治疗胆囊结石合并胆总管结石的微创优势显著,能缓解机体应激反应,加快术后康复速度,且安全性较高,值得临床推广.
Objective To explore the effects of laparoscope combined with choledochoscopy surgery on postoperative rehabilitation and stress response in patients with cholecystolithiasis combined with common bile duct stones.Methods From January 2019 to December 2021,50 patients with cholecystolithiasis combined with common bile duct stones who were diagnosed and treated in the Department of General Surgery of the hospital were selected as the research objects and divided into two groups according to different surgical plans,with 25 cases in each group.The control group was treated with laparotomy surgery,and the study group was treated with laparoscope combined with choledochoscopy surgery.The postoperative rehabilitation effect,the changes of stress response before and after operation and the incidence of postoperative complications were compared between the two groups.Results The first exhaust time,the first defecation time,the duration of pain,the time of getting out of bed and the length of hospital stay after operation in the study group were shorter than those in the control group,and the differences between the groups were statistically significant(P<0.05).3 days after operation,the levels of aldosterone(ALD),plasma renin activity(PRA)and AngiotensinⅡ(Ang-Ⅱ)in plasma of the two groups were higher than those before operation,however,the levels of ALD,PRA and Ang-Ⅱin plasma of the study group were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Laparoscope combined with choledochoscopy surgery in the treatment of cholecystolithiasis combined with common bile duct stones has significant minimally invasive advantages,which can relieve the body's stress response,speed up postoperative rehabilitation,and has high safety,which is worthy of clinical promotion.
作者
黄荣
HUANG Rong(The First of Department of General Surgery,Shandan County People's Hospital of Zhangye City,Gansu Province,Zhangye Gansu,734100,China)
出处
《反射疗法与康复医学》
2022年第20期157-160,共4页
Reflexology And Rehabilitation Medicine
关键词
胆囊结石
胆总管结石
腹腔镜手术
胆道镜手术
康复效果
应激反应
Cholecystolithiasis
Common bile duct stones
Laparoscope surgery
Choledochoscopy surgery
Rehabilitation effect
Stress response
作者简介
黄荣(1982-),男,甘肃山丹人,本科,主治医师,研究方向:普外科临床。
