ABSTRACT
Objective:To analyze the effect of laparoscopic cholecystectomy on quality of life index and liver function in patients with cholecystolithiasis.Methods:The clinical data of 160 patients with cholecystolithiasis in Zhejiang Wenzhou Tianning Hospital from January 2015 to January 2018 were retrospectively analyzed. Among them, 80 patients were treated with small incision cholecystectomy (control group), and 80 patients were treated with laparoscopic cholecystectomy (observation group). The operation time, bowel movement recovery time, visual analogue score (VAS) 24 h after operation, quality of life index, total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), C reactive protein (CRP) and tumor necrosis factor α (TNF-α) were compared between 2 groups.Results:The operation time, bowel movement recovery time and VAS 24 h after operation in observation group were significantly lower than those in control group: (57.8 ± 8.4) min vs. (89.8 ± 10.5) min, (25.3 ± 4.8) h vs. (38.8 ± 6.2) h and (7.33 ± 1.05) scores vs. (9.18 ± 1.85) scores, and there were statistical differences ( P<0.05). The quality of life index 1, 6 and 12 months after operation in observation group was significantly higher than that in control group: (113.2 ± 8.9) scores vs. (108.6 ± 7.4) scores, (126.9 ± 10.2) scores vs. (115.9 ± 9.3) scores and (134.3 ± 10.1) scores vs. (123.0 ± 8.1) scores, and there was statistical difference ( P<0.05). The CRP, TNF-α, DBIL, TBIL, AST and ALT 3 and 7 d after operation in observation group were significantly lower than those in control group, and there were statistical differences ( P<0.05). Conclusions:Laparoscopic cholecystectomy is effective in treating cholecystolithiasis and can effectively reduce the quality of life index and liver function.
ABSTRACT
Objective To investigate the effect of endoscopic minimally invasive surgery on thyroid tumors,and its influence on serum interleukin-6 (IL-6),cortisol (Cor) and norepinephrine (NE).Methods Eighty-two patients with thyroid tumors admitted to Tianning Hospital of Wenzhou from January 2016 to January 2019 were randomly divided into laparoscopic group (41 cases) and traditional group (41 cases) according to the digital table.Traditional thyroidectomy was performed in the traditional group,and laparoscopic minimally invasive surgery was performed in the laparoscopic group.The operative indicators and complications,pain at 24 and 48 hours after operation,and serum levels of IL-6,Cor and NE before and after operation were compared between the two groups.Results The amount of bleeding during operation [(25.46 ±7.82)mL] and the amount of drainage after operation[(73.24 ± 13.25) mL] in the laparoscopic group were less than those in the traditional group [(53.21 ± 9.97) mL and (107.38 ± 16.52)mL],the length of incision [(3.04 ± 0.45) cm] in the laparoscopic group was shorter than that in traditional group [(7.18 ±0.76) cm],and the operation time [(67.84 ± 15.46) min] in the laparoscopic group was shorter than that in traditional group [(98.73 ±25.31) min],the differences were statistically significant(t =14.023,10.323,30.014,6.669,all P ＜ 0.05).The incidence of postoperative complications in the laparoscopic group (4.88 ％) was lower than that in the traditional group (26.83 ％) (x2 =7.405,P ＜ 0.05).The VAS scores of the laparoscopic group at 24h [(3.64 ±0.82) points] and 48h [(2.53 ±0.57) points] after operation were lower than those of the traditional group [(5.37 ± 1.29) points and (3.70 ± 0.81) points] (t =7.247,7.564,all P ＜0.05).The serum levels of IL-6,Cor and NE in the two groups at 24 hours after operation were higher than those before operation (all P ＜ 0.05).The serum levels of IL-6 [(49.98 ± 10.21) ng/L],Cor [(125.63 ±17.68)ng/mL] and NE [(167.86 ± 13.42) ng/L] in the laparoscopic group 24 hours after operation were lower than those in the traditional group [(83.25 ± 14.62) ng/L,(167.51 ± 25.47)ng/mL and (209.81 ± 17.86) ng/L](t =11.947,8.649,12.024,all P ＜ 0.05).Conclusion Endoscopic minimally invasive surgery is effective in the treatment of thyroid neoplasms,which has little effect on stress response and can relieve pain and reduce postoperative complications.