腹腔镜治疗急性结石性胆囊炎的最佳手术时机研究  

作　　者：曹益[1] 

机构地区：[1]四川省广安岳池县中医医院泌尿外科,638300

出　　处：《当代医学》2013年第6期13-14,共2页Contemporary Medicine

摘　　要：目的探讨腹腔镜治疗急性结石性胆囊炎的最佳手术时机。方法对行腹腔镜治疗的125例急性结石性胆囊炎患者的临床资料进行回顾性分析,将发病至手术时间≤72h的65例患者和>72h的60例患者分别作为观察组和对照组,观察两组患者的中转开腹率、肛门排气时间、平均手术时间、术后疼痛时间、平均住院时间及术后并发症发生情况。结果观察组患者中转开腹率、肛门排气时间、平均手术时间、术后疼痛时间、平均住院时间分别为1.54%(、32.1±3.1)d(、5.6±10.4)min(、23.4±2.4)d(、2.6±0.3)d,明显短于对照组患者[16.67%、(55.9±3.4)d、(81.1±15.3)min、(55.4±2.6)d、(5.3±1.6)d],差异有统计学意义(P<0.05);观察组患者腹腔感染、肠瘘、胆漏、胸腔积液、切口感染发生率分别为10.77%、1.54%、4.62%、3.08%和7.69%,与对照组(13.33%、1.67%、6.67%、3.33%、10.00%)比较,差异无统计学意义(P>0.05)。结论腹腔镜治疗急性结石性胆囊炎最好在发病72h以内施行手术,选择正确的手术时机可以明显改善患者的术后状况。Objective To analyze the optimal timing of surgery about laparoscopic treatment for acute cholecystitis. Methods The clinical data of 125 patients with acute cholecystitis underwent laparoscopic treatment were retrospectively analyzed. 65 patients with operation time ≤72 h and 60 patients with operation time 〉 72 h were as the observation group and the control group. The converted to laparotomy rate, anus exhaust time, mean operative time, postoperative pain time, the average length of hospital stay, and postoperative complications of two groups were observed. Results The converted to laparotomy rate, anus exhaust time, mean operative time, postoperative pain time, the average length of hospital stay of observation group was 1.54%, （32.1±3.1）d, （50.6±10.4）min, （23.4±2.4）d, （2.6±0.3）d, which significantly shorter than the control group[16.67%, （55.9±3.4）d, （81.1±15.3）min, （55.4±2.6）d, （5.3±1.6）d]. The difference was significant（P0.05）. Conclusion The optimal timing of surgery about laparoscopic treatment for acute cholecystitis is within 72 h. The correct timing of surgery can significantly improve the patient＇s postoperative condition.

关 键 词：急性结石性胆囊炎 最佳手术时机 腹腔镜 

分 类 号：R657.4[医药卫生—外科学]