| 摘要: |
| 目的:观察开腹与腹腔镜胆囊切除术治疗酒精性肝硬化合并胆囊结石的治疗效果。方法:将本院肝胆外科诊为酒精性肝硬化合并胆囊结石且需行手术治疗的88 例患者纳入此次研究，按照随机数字表法将其分成腹腔镜组与开放手术组，每组各44 例。观察各组患者术中出血量、手术时间、术后排气时间及住院天数进行记录与统计，对比2 组患者肝功能(谷丙转氨酶、谷草转氨酶及总胆红素)与免疫指标(CD4+、CD8+、CD4+/ CD8+ 及CD3+)术前与术后的情况及并发症出现情况。结果:开放手术组患者术时出血量显著多于腹腔镜组，手术所行时间、术后排气时间与住院天数均明显长于腹腔镜组，有统计学差异(P ＜ 0.05)。2 组患者术前肝功能及免疫指标比较无统计学差异(P ＞ 0.05)；术后腹腔镜组肝功能指标水平低于开放手术组，术后腹腔镜组CD4+、CD4+/ CD8+ 及CD3+ 水平高于开放手术组，而CD8+ 水平低于开放手术组，有统计学差异(P ＜ 0.05)。开放手术组与腹腔镜组并发症的发生率依次为18.18%(8/44)与11.36%(5/44)，有统计学差异(P ＜ 0.05)。结论:酒精性肝硬化合并胆囊结石患者临床采用腹腔镜手术治疗可显著改善患者术时与术后一般情况和指标，减轻患者的免疫反应以及手术过程对肝功能的影响，且并发症出现情况低，其疗效确切。 |
| 关键词: 酒精性肝硬化 腹腔镜手术 免疫 并发症 胆囊结石 |
| DOI：10.3969/j.issn.1007-6948.2020.03.017 |
| 投稿时间：2019-11-12 |
| 基金项目: |
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| Analysis of the Efficacy and Complications of Laparoscopic Surgery for Patients with Alcoholic Cirrhosis complicated with Gallstone |
| ZHANG Liang,SUN Nai-hui |
| Tianjin Ninghe District Hospital, Tianjin 301500,China |
| Abstract: |
| Objective To observe the efficacy of laparoscopic surgery in patients with alcoholic cirrhosis complicated with gallstones and the occurrence of complications. Methods Eighty-eight patients who had been diagnosed with alcoholic cirrhosis complicated with gallstones and who underwent hepatobiliary surgery in our hospital were included in the study. They were divided into laparoscopic group and open operation group according to random number table (44 cases/group ). The bleeding volume during operation, the time of operation,the postoperative exhaust time and the number of hospital stays were recorded and counted. The two groups were compared the liver function ( alanine aminotransferase, albumin, aspartate aminotransferase complications of total bilirubin) and immune markers (CD4+, CD8+, CD4+/CD8+ and CD3+) in the preoperative and postoperative.Results The bleeding volume of the patients in the open operation group was significantly higher than that in the laparoscopic group. The time of surgery, postoperative exhaust time and length of hospital stay were significantly longer than those in the laparoscopic group (P <0.05). There were no significant differences in preoperative liver function and immune indexes between the two groups (P >0.05). The liver function index of the laparoscopic group was lower than that in the open operation group. The CD4+, CD4+/CD8+ and CD3+ of the postoperative laparoscopiclevels were higher than those of the open operation group, while the CD8+ level was lower. In the open operation group, there was a statistical difference (P <0.05). The incidence of complications in the open operation group and the laparoscopic group were 18.18% (8/44) and 11.36% (5/44) respectively,with a statistical difference (P <0.05). Conclusion Laparoscopic surgery for patients with alcoholic cirrhosis and gallstones can significantly improve the time and postoperative general conditions of patients, reduce the immune response of patients and the effect of surgical procedure on liver function. The complications are low and the curative effect is exact. |
| Key words: Alcoholic cirrhosis laparoscopic surgery immune complications gallstone |
