免氣腹與氣腹腹腔鏡膽囊切除術的對比研究

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1、免氣腹與氣腹腹腔鏡膽囊切除術的對比研究第15卷第7期2010年7月腹腔鏡外科雜志J0URNALOFLAPAROSCOPICSURGERYVo1.15.No.7Ju1.2010文章編號:1009—6612(2010)07—0489—04DOI:10.3969/j.issn.1009—6612.2010.07.004?專題研究?免氣腹與氣腹腹腔鏡膽囊切除術的對比研究宋天豹,姚健(1.瀘州醫(yī)學院,四川瀘州,646000;2.瀘州市人民醫(yī)院)【摘要】目的:探討免氣腹腹腔鏡膽囊切除術(1aparoscopicch0lecystect0y,LC)與氣腹LC的臨床

2、應用價值.方法:隨機抽取60例膽囊疾病患者,分為免氣腹LCI組與氣腹LC組各30例,同時選擇合并慢性阻塞性肺病或冠心病的膽囊炎患者10例為免氣腹LCⅡ組,進行臨床觀察和實驗研究.結果:免氣腹Lc在術后鎮(zhèn)痛藥應用,術后體溫,住院費用,并發(fā)癥,血流動力學指標及免疫功能等均優(yōu)于氣腹Lc.結論:(1)免氣腹LC具有手術創(chuàng)傷小,術后患者痛苦輕,住院費用少等優(yōu)點,優(yōu)于氣腹Lc,術中出血量,術后應用抗生素時間兩組差畀無統(tǒng)計學意義;(2)免氣腹Lc較氣腹LC在免疫功能方面更具優(yōu)越性;(3)氣腹改變血流動力學指標;(4)免氣腹腹腔鏡對因氣腹禁忌而失去常規(guī)腹腔鏡手術機會

3、的患者具有重要的臨床價值.【關鍵詞】膽囊切除術,腹腔鏡;氣腹,人工;免氣腹;白細胞介素類;血流動力學;對比研究中圖分類號:R657.4文獻標識碼:AComparativestudyofgaslessandpneumoperitoneumlaparoscopiccholecystectomySONGTian—bao1.YAOJianz.j.LuzhouMedi—calCollege,Luzhou646000,China;2.LuzhouPeople.~Hospital【Abstract】0bjective:Toinvestigatetheclinica

4、lapplicationvalueofnon—pneumoperitoneumlaparoscopiccholecystectomy(LC)andpneum0peritoneumLC.Methods:Sixtypatientswithgallbladderdiseasewererandomlydividedintonon—pneum0peritoneumLCIgroup(30cases)andLCgroup(30cases),and10patientswithgallbladderdisease,chronicobstructivepulmonary

5、diseasesorcoronaryartmTdiseasewereselectedasnon—pneumoperitoneumLCIIgroup.Clinicalobservationandexperimentstudyweredone.Re-suits:Non—pnenmoperitoneumLCwasbetterthanpneumoperitoneumLCinpostoperativeanalgesicadministration,bodytemperature,hospitalizationcost,complieations,hemodyn

6、amicsindexesandimmunefunction.Conclusions:(1)ComparedwithpneumoperitoneumLC,non—pneumoperitoneumLChastheadvantagesofslighttrauma,mildpain,anddecreasedeconomicburden.Thereisnosignificantdifferenceinthebleedingduringoperationandtimeofusingantibioticsafteroperation.(2)Non—pneum0pe

7、ritoneumLCgrouphasbetterinnnunefunction.(3)Pneum0perit0neumhasaremarkableinfluenceonthehemodynamicsindexes.(4)Forpneumoperitoneumcontra—indicatedpatientswhohavenoroutinelaparoscopicoperationchance,non?pneumoperjtoneumLChasimportantclinicalvalue.【Keywords】Cholecystectomy,laparos

8、copic;Pneumoperitoneum,artificial;Non—pneum0peritoneum