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身体对创伤的代谢和应激反应:由腹腔镜胆囊切除术和开腹胆囊切除术引起。

Metabolic and stress responses of the body to trauma: produced by the laparoscopic and open cholecystectomy.

作者信息

Haque Z, Rahman M, Siddique M A, Roy R K, Chowdhury R A, Rahman M M, Rabbi M A

机构信息

Sylhet MAG Osmani Medical College.

出版信息

Mymensingh Med J. 2004 Jan;13(1):48-52.

Abstract

Laparoscopic cholecystectomy is regarded as gold standard therapy for symptomatic gall stone disease. This study was done to compare the metabolic and stress responses between open and lapraroscopic cholecystectomy and to evaluate their significance in postoperative recovery. Thirty patients with symptomatic gall stone disease were treated with open and laparoscopic cholecystectomy on elective basis (14 versus 16). Three samples of blood were collected from each patient to investigate serum cortisol, adrenaline, nor-adrenaline, C-reactive protein and blood glucose level. The mean age of patients was 41.86+/-10.13 blood glucose and stress hormones (cortisol, adrenaline, nor adrenaline) and C-reactive protein all were found significantly raised in the postoperative period in open cholecystectomy than laparoscopic cholecystectomy group. The postoperative recovery was also prolonged in the open group. The obvious clinical advantages of laparoscopic cholecystectomy over open cholecystectomy is mainly because of less metabolic and stress response.

摘要

腹腔镜胆囊切除术被视为有症状胆结石疾病的金标准治疗方法。本研究旨在比较开腹胆囊切除术和腹腔镜胆囊切除术之间的代谢和应激反应,并评估它们在术后恢复中的意义。30例有症状胆结石疾病患者被择期行开腹胆囊切除术和腹腔镜胆囊切除术(14例对16例)。从每位患者采集三份血样,以检测血清皮质醇、肾上腺素、去甲肾上腺素、C反应蛋白和血糖水平。患者的平均年龄为41.86±10.13岁,发现开腹胆囊切除术组术后血糖、应激激素(皮质醇、肾上腺素、去甲肾上腺素)和C反应蛋白均显著高于腹腔镜胆囊切除术组。开腹组术后恢复时间也延长。腹腔镜胆囊切除术相对于开腹胆囊切除术明显的临床优势主要是由于代谢和应激反应较小。

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