Objective To investigate the application of perioperative comprehensive management in patients with choledocholithiasis combined with acute cholangitis by endoscopic retrograde cholangiopancreatography(ERCP)and laparoscopic cholecystectomy(LC).Methods Eighty patients with choledocholithiasis complicated with acute cholangitis who received ERCP+LC were randomly divided into two groups.The control group was given perioperative routine management,and the observation group was given perioperative comprehensive management.SPSS 25.0 software was used to analyze the data.Perioperative indexes,hemodynamic indexes,inflammatory emergency indexes and myocardial injury markers were presented with((x)±s),independent t test was used for comparison between groups;The statistical data such as complication rate were compared by x2 test.P＜0.05 was considered statistically significant.Results The length of hospital stay in the observation group was better than that in the control group(P＜0.05).After induction of anesthesia(T1),immediately after intubation(T2),5 min after pneumoperitoneum(T3),and at the end of operation(T4),the fluctuation of heart rate(HR)and mean arterial pressure(MAP)in the observation group was smaller than that in the control group(P＜0.05).One day after operation,the inflammatory stress indexes in the observation group were lower than those in the control group(P＜0.05).3 days after operation,the myocardial injury indexes in the observation group were lower than those in the control group(P＜0.05).There was no significant difference in the total complication rate between the two groups(P＞0.05).Conclusion Perioperative comprehensive management intervention for choledocholithiasis patients with acute cholangitis treated with ERCP+LC can effectively maintain the hemodynamic stability of patients,reduce postoperative inflammatory stress response and myocardial damage,which is conducive to postoperative rehabilitation of patients,and is safe and feasible.
维普
万方数据