文章摘要
张强,侯丹杰,张爱辉,等.微创保胆取石术对小儿胆囊结石的临床效果及血清炎性因子水平的影响[J].安徽医药,2020,24(12):2474-2477.
微创保胆取石术对小儿胆囊结石的临床效果及血清炎性因子水平的影响
Clinical effect of minimally invasive gallblade?preserving cholelithotomy for children with cholecystolithiasis and its influence on serum inflammatory factors
  
DOI:10.3969/j.issn.1009?6469.2020.12.035
中文关键词: 胆囊结石病  最小侵入性外科手术  胆囊切除术,腹腔镜  儿童  保胆取石术
英文关键词: Cholecystolithiasis  Minimally invasive surgical procedures  Cholecystectomy,laparoscopic  Child  Gallblade? preserving cholelithotomy
基金项目:
作者单位
张强 西安市儿童医院胸外科陕西西安 710003 
侯丹杰 西安市儿童医院泌尿外科一病区陕西西安 710003 
张爱辉 西安市儿童医院胸外科陕西西安 710003 
张生 西安市儿童医院普外科一病区陕西西安 710003 
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中文摘要:
      目的探讨在胆囊结石病儿中应用微创保胆取石术的疗效及其对病儿血清炎性因子水平的影响。方法回顾性分析 2010年 1月至 2019年 5月共计 62例西安市儿童医院收治的胆囊结石病儿的临床资料,将 32例行腹腔镜胆囊切除术的病儿纳入对照组,将 30例行微创保胆取石术的病儿纳入观察组。比较两组病儿手术时间、术中出血量、肛门排气时间及住院时间;比较两组病儿手术前、术后 1d及术后 3d血清白细胞介素 ?6(IL?6)、白细胞介素 ?8(IL?8)、超敏 C反应蛋白(hs?CRP)及肿瘤坏死因子 α(TNF?α)水平;比较两组病儿术后并发症发生情况。结果两组病儿手术时间相比较差异无统计学意义(P> 0.05),观察组病儿术中出血量、肛门排气时间及住院时间均少于对照组病儿[(19.03±6.23)mL比(40.97±8.94)mL;(19.63±5.56)h比(23.06±6.03)h;(4.50±1.20)d比(6.25±1.61)d](P<0.05);术后 1d及术后 3d,观察组病儿血清 IL?6、IL?8、 hs?CRP及 TNF?α水平均低于对照组病儿及手术前(P<0.05);观察组病儿并发症总发生率(6.7%)低于对照组病儿(28.1%)(P<0.05)。结论微创保胆取石术治疗小儿胆囊结石能够减少炎性因子的表达且创伤小,可有效改善临床症状且术后并发症相对较低。
英文摘要:
      Objective To explore the effect of minimally invasive gallblade?preserving cholelithotomy in children with cholecystoli?thiasis and its influence on serum inflammatory factors.Methods The clinical data of 62 children with cholecystolithiasis who were admitted to Xi’an Children’s Hospital from January 2010 to May 2019 were retrospectively analyzed.32 children who under?went laparoscopic cholecystectomy were included in the control group,and 30 children who underwent minimally invasive gallblade?preserving cholelithotomy were included in the observation group.The operation time,intraoperative blood loss,anal exhaust time and hospitalization time were compared between the two groups.The serum levels of IL?6,IL?8,hs?CRP and TNF?α in the two groups were compared before surgery,1 day after surgery and 3 days after surgery.Postoperative complications were compared be? tween the two groups.Results There was no difference in operative time between the two groups(P>0.05),and the intraoperative blood loss,anal exhaust time and hospital stay time in the observation group were all less than those in the control group[(19.03± 6.23)mL vs.(40.97±8.94)mL;(19.63±5.56)h vs.(23.06±6.03)h;(4.50±1.20)d vs.(6.25±1.61)d](P<0.05).Both 1 day and 3 days after surgery,the serum levels of IL?6,IL?8,hs?CRP and TNF?α in the observation group were lower than those in the con? trol group and before surgery(P<0.05).The total incidence of complications in the observation group(6.7%) was lower than 28.1% of the control group(P<0.05).Conclusion The minimally invasive gallblade?preserving cholelithotomy used for the treat?ment in children with cholecystolithiasis can reduce the expression of inflammatory factors,have little trauma,improve clinical symptoms effectively and have low postoperative complications.
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