贵州医科大学学报

2016, v.41;No.190(07) 862-864+868

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超声刀腹腔镜胆囊切除术后患者白细胞计数及分类、血清C反应蛋白水平变化
Changes of Inflammatory Parameters after Laparoscopic Cholecystectomy by Harmonic Scalpel

闵泽;马浩;周凯;
MIN Ze;MA Hao;ZHOU Kai;Department of General Surgery,Anshun City People's Hospital;

摘要(Abstract):

目的:探讨超声刀腹腔镜胆囊切除术后患者炎性指标的变化。方法:358例行超声刀腹腔镜胆囊切除术患者作为观察组,123例行电凝钩胆囊切除术患者作为对照组,记录2组患者平均手术时间、术中出血量、术后住院时间及住院费用,比较2组患者手术前、术后1 d及1周时白细胞计数(WBC)、中性粒细胞和淋巴细胞分类、血清C反应蛋白(CRP)水平变化。结果:观察组手术时间、术中出血量少于对照组(P<0.05),术后住院时间及住院费用与对照组比较,差异无统计学意义(P>0.05);2组患者术前WBC计数、中性粒细胞和淋巴细胞比例、血清CRP水平比较,差异无统计学意义(P>0.05),术后1 d及1周时4项指标均高于手术前,差异有统计学意义(P<0.05),术后1周较1 d有所降低,观察组降低更明显,差异有统计学意义(P<0.05)。结论:超声刀腹腔镜胆囊切除术效果优于电凝钩胆囊切除术,术后炎症反应轻。
Objective: To investigate the changes of inflammatory parameters after laparoscopic cholecystectomy( LC) by harmonic scalpel. Method: 358 cases of patients with gallbladder disease undergoing LC by Olympus harmonic scalpel were enrolled in this study as observation group while 123 cases of patients with gallbladder disease undergoing electrocantery cholecystectomy as control group. The operation time,blood loss,postoperative hospital stay,hospitalization expenses were recorded in both group. Meanwhile,the leukocyte count( WBC),percentage of neutrophil granulocytes,percentage of lymphocyte and CRP expression level were compared between the observation group and control group before surgery,1 day after surgery and 1 week after surgery. Results: The operation time and blood loss in observation group were less than those in control group( P < 0. 05). There was no significant difference in postoperative hospital stay and hospitalization expenses between the two groups( P >0. 05). At 1 day after surgery and 1 week after surgery,WBC,percentage of neutrophil granulocytes,percentage of lymphocyte and CRP level were higher than before surgery( P < 0. 05). Compared with at1 day after surgery,the 4 indicators decreased to some extent at 1 week after surgery and the 4 indicators deceased more significantly in observation group( P < 0. 05). Conclusion: Laparoscopic cholecystectomy by harmonic scalpel is better than electrocantery cholecystectomy in its low inflammatory reaction after surgery.

关键词(KeyWords): 胆囊切除术,腹腔镜;C反应蛋白质;白细胞计数;淋巴细胞;超声刀
cholecystectomy,laparoscopic;C reactive protein;white blood cell;lymphocyte;ultrasound knife

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作者(Author): 闵泽;马浩;周凯;
MIN Ze;MA Hao;ZHOU Kai;Department of General Surgery,Anshun City People's Hospital;

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DOI: 10.19367/j.cnki.1000-2707.2016.07.030

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