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目的观察非急性期腹腔镜胆囊切除术对老年患者血清应激指标的影响。方法行腹腔镜胆囊切除术的老年患者35例纳入观察组,同期行开腹式胆囊切除术老年患者30例作为对照组。比较两组患者手术一般指标、血清应激指标。结果观察组手术时间为(89.5±22.8)min,术中出血量为(67.5±20.4)ml,下床时间为(23.3±5.8)h。对照组手术时间为(86.7±24.7)min,术中出血量为(118.9±37.2)ml,下床时间为(30.1±7.6)h。两组手术时间比较差异无统计学意义(P>0.05);观察组术中出血量少于对照组,下床时间早于对照组,差异有统计学意义(P<0.05)。与术前1 d比较,术后1 d两组患者C反应蛋白、空腹血糖及皮质醇水平均有所升高,但观察组低于对照组,差异有统计学意义(P<0.05)。结论腹腔镜胆囊切除术对老年患者血清中应激指标影响较开腹手术小,这可能是腹腔镜胆囊切除术患者术后恢复快的原因之一。
Objective To observe the effect of non-acute laparoscopic cholecystectomy on serum stress index in elderly patients. Methods 35 cases of elderly patients undergoing laparoscopic cholecystectomy were enrolled in the observation group. 30 cases of elderly patients undergoing open cholecystectomy during the same period were selected as the control group. The two groups of patients were compared with the general indicators of surgery, serum stress indicators. Results The operation time of the observation group was (89.5 ± 22.8) min, the intraoperative blood loss was (67.5 ± 20.4) ml and the time to bed was (23.3 ± 5.8) h. The operation time of the control group was (86.7 ± 24.7) min, the intraoperative blood loss was (118.9 ± 37.2) ml and the time to bed was (30.1 ± 7.6) h. There was no significant difference in operation time between the two groups (P> 0.05). The bleeding volume in the observation group was less than that in the control group, and the time to bed was earlier than that in the control group. The difference was statistically significant (P <0.05). The levels of C-reactive protein, fasting blood glucose and cortisol in both groups were significantly higher than those on the 1st day after operation, but the difference was statistically significant in the observation group (P <0.05). Conclusion laparoscopic cholecystectomy in elderly patients with serum stress indicators than laparotomy less surgery, which may be laparoscopic cholecystectomy patients with rapid recovery one of the reasons.