免气腹与气腹腹腔镜胆囊切除术的对比研究

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1、免气腹与气腹腹腔镜胆囊切除术的对比研究第15卷第7期2010年7月腹腔镜外科杂志J0URNALOFLAPAROSCOPICSURGERYVo1.15.No.7Ju1.2010文章编号:1009—6612(2010)07—0489—04DOI:10.3969/j.issn.1009—6612.2010.07.004?专题研究?免气腹与气腹腹腔镜胆囊切除术的对比研究宋天豹,姚健(1.泸州医学院,四川泸州,646000;2.泸州市人民医院)【摘要】目的:探讨免气腹腹腔镜胆囊切除术(1aparoscopicch0lecystect0y,LC)与气腹LC的临床

2、应用价值.方法:随机抽取60例胆囊疾病患者,分为免气腹LCI组与气腹LC组各30例,同时选择合并慢性阻塞性肺病或冠心病的胆囊炎患者10例为免气腹LCⅡ组,进行临床观察和实验研究.结果:免气腹Lc在术后镇痛药应用,术后体温,住院费用,并发症,血流动力学指标及免疫功能等均优于气腹Lc.结论:(1)免气腹LC具有手术创伤小,术后患者痛苦轻,住院费用少等优点,优于气腹Lc,术中出血量,术后应用抗生素时间两组差畀无统计学意义;(2)免气腹Lc较气腹LC在免疫功能方面更具优越性;(3)气腹改变血流动力学指标;(4)免气腹腹腔镜对因气腹禁忌而失去常规腹腔镜手术机会

3、的患者具有重要的临床价值.【关键词】胆囊切除术,腹腔镜;气腹,人工;免气腹;白细胞介素类;血流动力学;对比研究中图分类号:R657.4文献标识码: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