腹腔镜胆总管探查取石术治疗复杂性肝内胆管结石的效果及对血清炎症因子的影响

Effect of laparoscopic total biliary lithotomy in treatment of complicated intrahepatic bile duct stones and its effect on serum inflammatory factor

摘要:

目的 分析腹腔镜胆总管探查取石术治疗复杂性肝内胆管结石的临床价值。方法 选取2018年2月－2020年2月该院复杂性肝内胆管结石患者106例，随机分为常规组（n = 53）和治疗组（n = 53），治疗组接受腹腔镜胆总管探查取石术，常规组接受传统开腹胆总管探查取石术。比较两组患者治疗后的手术效果、炎症因子水平、并发症发生率、结石复发率和生活质量评分。结果 治疗组肛门恢复排气时间、住院时间和手术时间均明显短于常规组，术中出血量明显少于常规组（P < 0.05）。术后3 d，C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和白细胞介素-1（IL-1）水平明显低于常规组（P < 0.05）。治疗组并发症发生率和结石复发率明显低于常规组（P < 0.05），生活质量评分明显高于常规组（P < 0.05）。结论 采用腹腔镜胆总管探查取石术治疗肝内胆管结石，不仅可以提高治疗效果，降低结石复发率，还抑制炎性因子释放，促进机体恢复。

Abstract:

Objective To analyze the clinical value of applying laparoscopic duct lithotomy in patients with complicated intrahepatic bile duct stones.Methods 106 patients with complicated intrahepatic bile duct stones were selected from February 2018 to February 2020. Patients were randomized into routine groups (n = 53, underwent traditional laparotomy), and treatment groups (n = 53, underwent laparoscopic bile duct lithotomy). The surgical effect, levels of inflammatory factors, complication incidence, recurrence rates of disease stones, and quality of life scores were compared between the two groups.Results The anal recovery and exhaust time, hospital stay and operation time in the treatment group were significantly shorter than those in routine group, and the amount of intraoperative bleeding was significantly less than that in routine group (P < 0.05). Three days after operation, the levels of C reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-1 (IL-1) in treatment group were significantly lower than those in routine group (P < 0.05), the complication rate and stone recurrence were lower than those in routine group (P < 0.05), and the quality of life score was higher than that in routine group (P < 0.05).Conclusion Laparoscopic bile duct lithotomy in patients with complicated intrahepatic bile duct stones not only increases the treatment effect, reduces the recurrence of the disease, but also facilitates the removal of inflammatory factors and promotes the body recovery.