摘要
目的分析腹腔镜胆囊切除术(LC)对胆结石患者血清胆囊收缩素A型受体(CCK-A)、固醇调节元件结合蛋白2(SREBP-2)及胆红素(TCB)水平的影响。方法选取2017年6月至2019年4月我院收治的胆结石患者140例,依据非随机临床同期对照研究及患者自愿原则分为观察组合和对照组各70例。对照组予以小切口胆囊切除术(MC),观察组予以LC术,比较两组手术一般情况、手术前后血清CCK-A、SREBP-2、TCB、疼痛(简化McGill疼痛问卷)、并发症发生率。结果观察组手术时间、术后住院时间、肠鸣音复常时间、下地活动时间均短于对照组,术中出血量较对照组低(P<0.05);观察组术后CCK-A水平高于对照组,SREBP-2、TCB低于对照组(P<0.05);观察组术后1、3、7 d McGill评分低于对照组(P<0.05),术后1个月内并发症发生率低于对照组(P<0.05)。结论与MC术相比,LC术治疗胆结石疗效更好,可有效促进患者术后恢复,提高CCK-A水平,下调SREBP-2、TCB及炎症因子水平,降低疼痛和并发症风险,值得临床推广实践。
Objective To analyze the effects of laparoscopic cholecystectomy(LC)on serum levels of cholecystokinin A receptor(CCK-A),sterol regulatory element binding protein 2(SREBP-2)and bilirubin(TCB)in patients with gallstones.Methods We selected 104 patients with gallstones admitted to our hospital between June 2017 and April 2019.They were divided into observation and control groups according to the non-randomized clinical concurrent control study and the voluntary principle of patients,70 in each group.The control group was treated with mini-cholecystectomy(MC),while the observation group was treated with LC.The general conditions of surgery,serum levels of CCK-A,SREBP-2,TCB,pain degree(simplified McGill pain questionnaire),and the incidence of complications were compared between the two groups.Results The operation time,postoperative hospital stay,recovery time of bowel sounds,and time of underground activities were shorter and the intraoperative blood loss in the observation group was less than those in the control group(P<0.05).After surgery,the CCK-A level was higher while SREBP-2 and TCB were lower in the observation group than those in the control group(P<0.05).The McGill scores of the observation group after 1 day,3 days and 7 days of surgery were lower than those of the control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group within 1 month after surgery(P<0.05).Conclusion Compared with MC,LC is more effective in the treatment of gallstones.It can effectively promote the postoperative recovery,increase CCK-A levels,down-regulate levels of SREBP-2,TCB and inflammatory factors,and reduce the risk of pain and complications.It is worthy of clinical practice.
作者
万波
母齐鸣
贺伟
WAN Bo;MU Qi-ming;HE Wei(Department of Hepatobiliary and Pancreatic Surgery,363 Hospital,Chengdu 610041,China)
出处
《实用医院临床杂志》
2020年第3期56-59,共4页
Practical Journal of Clinical Medicine
