腹腔镜胆囊切除术治疗急性胆囊炎合并胆汁性腹膜炎术后感染状况研究.docVIP

腹腔镜胆囊切除术治疗急性胆囊炎合并胆汁性腹膜炎术后感染状况研究 　　[摘要]目的 比?^急性胆囊炎合并胆汁性腹膜炎患者分别行腹腔镜胆囊切除术（LC）与传统开腹胆囊切除术（OC）后对机体免疫反应、系统性炎症的影响。方法 选取我院2015年11月～2016年11月收治的100例急性结石性胆囊炎患者，均合并有胆汁性腹膜炎，按照随机数字表法分为观察组和对照组，每组各50例。观察组患者行LC治疗，对照组患者开展OC治疗。观察与比较两组术后并发症发生情况、住院天数与死亡情况；比较两组患者术后中性粒细胞、白介素-6（IL-6）、红细胞沉降率（ESR）及血清C反应蛋白（CRP）的水平变化情况。结果 观察组患者住院天数[（5.3±2.6）d]明显短于对照组[（10.1±3.4）d]（P0.05）；观察组患者术后腹腔脓肿发生率（6.0%）、病死率（4.0%）显著低于对照组（36.0%、28.0%）（P0.05）。术后第 1、3、6天时，观察组患者中性粒细胞、血清CRP、ESR与IL-6水平比对照组低，差异均有统计学意义（P0.05）。结论 与对照组比较，LC能降低系统炎症反应水平，促进短暂免疫防御的构建，还能最大化降低术后感染风险，临床应用价值高。 　　[关键词]腹腔镜；急性胆囊炎；胆汁性腹膜炎；胆囊切除术；感染 　　[中图分类号] R657.41 [文献标识码] A [文章编号] 1674-4721（2018）1（c）-0024-03 　　Study on postoperative infection of laparoscopic cholecystectomy for acute cholecystitis complicated with biliary peritonitis 　　ZHOU Xiao-long ZENG Xian-min 　　Department of General Surgery，Jishui People′s Hospital，Jiangxi Province，Jishui 331600，China 　　[Abstract]Objective To compare the effects of laparoscopic cholecystectomy（LC） and traditional open cholecystectomy（OC） on immune response and systemic inflammation in patients with acute cholecystitis complicated with biliary peritonitis.Methods From November 2015 to November 2016，100 cases of acute cholecystitis patients were complicated with bile peritonitis，were randomly divided into two groups according to the random number table method，50 cases in each group.The patients of the observation group were used laparoscopic cholecystectomy treatment.The patients of the control group were used the traditional open cholecystectomy treatment.The postoperative complications，length of stay and death were observed and compared between the two groups.The changes of neutrophil，IL-6 red cell sedimentation rate （ESR） and serum CRP level were compared between the two groups.Results The hospital stay in the observation group （[5.3±2.6] d） was compared to the control group （[10.1±3.4] d），significantly less than the latter （P 　　[Key words]Laparoscopy；Acute cholecystitis；Biliary peritonitis；Cholecystectomy；Infectio