腹腔镜胆囊切除术75例病人术后急性炎症应激反应的研究.docVIP

腹腔镜胆囊切除术75例病人术后急性炎症应激反应的研究 　　[摘要] 目的 探讨腹腔镜胆囊切除术对病人机体急性炎症应激反应的影响。 方法 选取该院行腹腔镜胆囊切除术的病人75例作为研究组，选取同期行开腹胆囊切除术手术的病人22例作为对照组，比较两组病人术后急性验证应激反应情况。结果 术后1、5、6、7d发生全身炎症反应的病人研究组分别为52.0%、13.33%、8.0%、0%，对照组分别为77.27%、27.27%、18.18%、13.64%，研究组全身炎症反应病人明显少于对照组，差异有统计学意义（P0.05）；两组病人术后12、24、36 h CRP表达水平均较术前有显著升高（P0.01），术后12 h、24 h CRP表达水平研究组分别为（25.8±10.5）mg/L、（54.7±20.8）mg/L，对照组分别为（40.9±12.9）mg/L、（66.9±21.4）mg/L，研究组明显低于对照组，差异有统计学意义（P0.05），术后36 h两组差异无统计学意义。结论 腹腔镜胆囊切除术较开腹手术炎症反应更轻，术前必须加强对长时间气腹缺血造成的氧化应激的重视，积极采取相应的措施，加快病人恢复。 　　[关键词] 腔镜胆囊切除术；急性炎症；应激反应 　　[中图分类号] R657.4 [文献标识码] A [文章编号] 1674-0742（2014）05（a）-0117-02 　　[Abstract] Objective To investigate the effect of laparoscopic cholecystectomy on emergency response to acute inflammation patient body. Methods 75 patients treated by laparoscopic cholecystectomy from September，2010 to September，2013 in our hospital as study group， select the same period underwent open cholecystectomy operation 22 cases of patients as the control group， compared two groups of patients after acute verification emergency response. Results The patients in the study group after 1， 5， 6， 7d incidence of systemic inflammatory response were 52%， 13.33%， 8%， 0%， control group were 77.27%， 27.27%， 18.18%， 13.64%， systemic inflammatory response of patients in study group were significantly less than the control group（P0.05）； two groups of patients after 12 h， 24 h， 36 h CRP expression levels were significantly increased（P0.01）， after 12 h， 24 h CRP expression group research levels were （25.8±10.5） mg/L， （54.7±20.8） mg/L， the control group not （40.9±12.9） mg/L， （66.9±21.4） mg/L， the study group was significantly lower than that of the control group （P0.05）， postoperative 36h was not significant difference between the two groups. Conclusion laparoscopic cholecystectomy compared with open operation inflammation lighter， preoperative must strengthen to oxidative stress caused by long time pneumoperitoneum ischemia attention， active measures， to speed up the patients recover