CAJ | 학술논문

目的:探讨腹腔镜胆囊切除术CO2气腹对于糖尿病患者术后肝功能的影响.方法:选择2013年1月-2014年12月于本院行胆囊切除术的胆囊结石伴慢性胆囊炎合并糖尿病的患者60例作为研究对象,根据术中气腹压水平分为Ⅰ、Ⅱ、Ⅲ 3组,每组20例,Ⅰ、Ⅱ组均行腹腔镜胆囊切除术,气腹压力分别为为12、15 mm Hg;Ⅲ组行开腹胆囊切除术.患者于术前1 d,术后1、24、48、72 h分别测定血清中ALT、AST及TBIL的浓度.结果:Ⅰ、Ⅱ组术后1、24、48 h血清ALT、AST、TBIL浓度均高于术前及Ⅲ组,Ⅱ组术后72 h血清ALT、AST、TBIL浓度均高于术前及Ⅲ组,比较差异均有统计学意义(P<0.01).Ⅲ组术后血清ALT、AST、TBIL浓度也较术前升高,但仅术后24 h高于术前,比较差异均有统计学意义(P<0.05).Ⅱ组术后各时间点血清ALT、AST、TBIL均高于Ⅰ组,比较差异均有统计学意义(P<0.05).结论:糖尿病患者采用常规气腹压力引起的术后肝功能异常程度相对采用高气腹压力明显较轻.
목적:탐토복강경담낭절제술CO2기복대우당뇨병환자술후간공능적영향.방법:선택2013년1월-2014년12월우본원행담낭절제술적담낭결석반만성담낭염합병당뇨병적환자60례작위연구대상,근거술중기복압수평분위Ⅰ、Ⅱ、Ⅲ 3조,매조20례,Ⅰ、Ⅱ조균행복강경담낭절제술,기복압력분별위위12、15 mm Hg;Ⅲ조행개복담낭절제술.환자우술전1 d,술후1、24、48、72 h분별측정혈청중ALT、AST급TBIL적농도.결과:Ⅰ、Ⅱ조술후1、24、48 h혈청ALT、AST、TBIL농도균고우술전급Ⅲ조,Ⅱ조술후72 h혈청ALT、AST、TBIL농도균고우술전급Ⅲ조,비교차이균유통계학의의(P<0.01).Ⅲ조술후혈청ALT、AST、TBIL농도야교술전승고,단부술후24 h고우술전,비교차이균유통계학의의(P<0.05).Ⅱ조술후각시간점혈청ALT、AST、TBIL균고우Ⅰ조,비교차이균유통계학의의(P<0.05).결론:당뇨병환자채용상규기복압력인기적술후간공능이상정도상대채용고기복압력명현교경.
Objective:To investigate the influence of CO2 pneumoperitoneum on liver function in diabetic patients who received laparoscopic cholecystectomy.Method:60 patients who received cholecystectomy in our hospital from January 2013 to December 2014 were selected as the research objects.They were all with gallbladder stones, chronic cholecystitis and diabetes mellitus.They were divided into group Ⅰ,group Ⅱ and group Ⅲ according to the intra-abdominal pressures of CO2 pneumoperitoneum,with each group 20 cases.Group Ⅰ and group Ⅱ were given laparoscopic cholecystectomy with pneumoperitoneum pressures 12 and 15 mm Hg respectively.Group Ⅲ was given open cholecystectomy.1 day before operation and 1,24,48 and 72 hours after operation,venous blood was collected to determine the concentrations of ALT,AST and TBIL in serum.Result:1,24 and 48 hours after operation,the levels of ALT,AST and TBIL in group Ⅰ and group Ⅱ were significantly higher than those before operation and those in group Ⅲ.72 hours after operation,the levels of ALT,AST and TBIL in group Ⅱ were significantly higher than those before operation and those in group Ⅲ.The differences above were all statistically significant(P<0.01).After operation,the levels of ALT,AST and TBIL in group Ⅲ were higher than those before operation,but only 24 hours after operation,the differences were statistically significant(P<0.05).The levels of ALT,AST,and TBIL in group Ⅱ were significantly higher than those in group Ⅰ at all times after operation,the differences were statistically significant(P<0.05). Conclusion:Diabetic patients who use conventional pneumoperitoneum pressure in laparoscopic cholecystectomy have less abnormal liver function than high pneumoperitoneum pressure.