腹腔镜胆囊切除术对患者肝脏功能影响网

[摘要] 目的 观察腹腔镜胆囊切除术对患者肝脏功能的影响。 方法 本院需行胆囊切除术的64例患者，按照病情及患者意愿分为腹腔镜组38例及开腹组26例，腹腔镜组采取腹腔镜胆囊切除术，开腹组采取传统开腹胆囊切除术。观察两组术前、术后不同时间段血清总胆红素（T-BiL）、碱性磷酸酶（ALP）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）变化。 结果 术前、术后1、3、5 d两组间T-BiL、ALP、ALT、AST比较差异均无统计学意义（P > 0.05）；两组术后1、3 d T-BiL、ALT、AST均较术前升高，两组与术前比较差异均有统计学意义（P < 0.05）；术后5 d T-BiL、ALP、ALT、AST均与术前比较差异无统计学意义（P > 0.05）。 结论 腹腔镜胆囊切除术后短期内对肝脏功能有所影响，但是术后5 d均可恢复正常。腹腔镜胆囊切除是安全的。
[关键词] 腹腔镜；开腹手术；胆囊切除术；肝脏功能
[] A[文章编号] 1674-4721（2012）07（c）-0059-02
The influence of laparoscopic cholecystectomy on patients' liver function
ZENG Jinglong ZHANG Zhanhui ZENG Zhixiang
General surgery dept, People's Hospital of Luxi County of Pingxiang City in Jiangxi Province, Luxi 337200, China
[Abstract] Objective To observe the influence of laparoscopic cholecystectomy on patients' liver function. Methods Clinical data of 64 patients who need cholecystectomy were divided into laparoscopic group (38 cases) and open group (26 cases) according to the condition and patients' will, patients in laparoscopic group were given laparoscopic cholecystectomy, while open group received the traditional open cystic resection. Serum total bilirubin (T-BiL), alkaline phosphatase (ALP), alanine amino shift enzyme (ALT), aspartate amino shift enzyme (AST) change before surgery and in postop

源于：论文结论www.udooo.com

erative different period were observed. Results T-BiL, ALP, ALT, AST before operation and 3 d, 1 d, 5 d after opration between two groups had no statistical difference (P > 0.05); 1 and 3 d after operation, T-BiL, ALT, AST rised in both two groups, there were statistical differences (P < 0.05); T-BiL, ALP, ALT, AST at 5 d after operation compared with the preoperative, there were no statistical differencse (P > 0.05). Conclusion Liver function may be influenced by laparoscopic cholecystectomy in short period after operation, but it can return to normal 5 d after operation. Laparoscopic cholecystectomy is safe.
[Key words] Laparoscope; Laparotomy; Cholecystectomy; Liver function
慢性胆囊炎及胆结石是外科常见病及多发病，腹腔镜胆囊切除术及传统开腹手术均是临床手术治疗慢性胆囊炎及胆结石的主要术式。为了观察腹腔镜胆囊切除术后患者肝功能影响，笔者对本院行胆囊切除术的患者手术前后肝脏功能进行了检测，现将结果报道如下：

1 资料与方法

1.1 一般资料

本院外科2011年1月～2012年4月共收治慢性胆囊炎及胆结石患者64例。根据病情及患者对手术术式选择的意愿分组，其中行腹腔镜胆囊切除术者38例（腹腔镜组），行传统开腹手术切除胆囊者26例（开腹组）。腹腔镜组中男性22例，女性16例，平均年龄（42.24±9.83）岁，包括慢性胆囊炎17例，胆结石21例；开腹组中男性15例，女性11例，平均年龄（41.98±10.12）岁，包括慢性胆囊炎12例，胆结石14例。两组在年龄、性别、病种方面比较差异无统计学意义（P > 0.05）。

1.2 方法

开腹组采取传统开腹胆囊切除术，在连续硬膜外麻醉下进行手术，手术方法按照常规开腹手术操作进行。腹腔镜组采取腹腔镜胆囊切除术，在静脉复合全身麻醉下进行手术，手术采用四孔法，术中以CO2维持气腹，气腹压力保持在12～13 mm Hg，术中用电凝钩将胆囊从胆囊床分离后，常规使用钛夹钳钳夹胆囊动脉及胆囊管，后丝线双重结扎，切除胆囊，胆囊床电凝止血，观察无渗出，结束手术。

源于：查抄袭率本科毕业论文www.udooo.com