腹腔镜与传统开腹手术治疗急性结石性胆囊炎的疗效对比研究  

Comparative Study of Laparoscopic and Traditional Open Surgery in the Treatment of Acute Gallstone Cholecystitis

作　　者：王继元[1] 姜保成[1] 陆艺[1] 钱桦[1] 袁野[1] 刘涛[1] 费建平[1] 

机构地区：[1]上海交通大学附属苏州九龙医院普外科,上海215021

出　　处：《中外医疗》2016年第16期184-185,190,共3页China & Foreign Medical Treatment

摘　　要：目的探讨急性结石性胆囊炎治疗的有效术式。方法方便选取90例于2013年8月—2015年8月期间该院接收的急性结石性胆囊炎患者,根据手术方式不同分为对照组与实验组,分别为开腹法胆囊切除术(OC)和腹腔镜法胆囊切除术(LC),观察两组疗效。结果实验组手术时间、术后肛门排气时间、术中出血量、住院时间、术后24 h疼痛评分分别为(43.2±9.6)min、(20.6±6.8)min、(34.5±9.7)m L、(4.5±1.2)d、(2.2±0.8)分,均显著低于对照组的(83.5±13.6)min、(52.8±12.3)min、(62.8±16.3)m L、(7.9±3.6)d、(4.8±1.2)分,P<0.05,差异具有统计学意义;术后,两组PA水平对比均有下降,CRP水平两组均显著上升,实验组PA、CRP分别为(150.4±38.2)g/L、(58.3±10.2)mg/L,对照组分别为(130.5±48.3)g/L、(91.6±18.3)mg/L,两组对比差异有统计学意义(P<0.05),实验组较对照组并发症发生率显著要低(P<0.05),分别为4.4%、20.0%。结论急性结石性胆囊炎采用LC治疗,术后胃肠功能恢复快,可显著改善炎症因子水平,术后并发症发生率低,是一种安全可行的手术方式。Objective To study the effective way in the treatment of acute calculous cholecystitis（ACC）. Methods Convenient selection 90 ACC patients treated from August 2013 to August 2015 in our hospital were selected and divided into control group（OC） and test group（LC） according to different therapies. The curative effect was observed. Results The test group operation time, postoperative anal exhaust time, intraoperative blood loss, hospitalization time, postoperative 24 h pain score was（43.2 ±9.6） min,（20.6 ± 6.8） min,（34.5 ± 9.7） ml,（4.5± 1.2） D,（2.2 ± 0.8）, were significantly lower than that of the control group（83.5 ±13.6） min（52.8±12.3） min（62.8 ± 16.3） ml（7.9 ±3.6）, D（4.8 ± 1.2）, P〈0.05, the difference was significant; after operation, two groups of PA contrast levels were decreased, CRP levels of the two groups were significantly increased. The experimental group PA and CRP were（150.4±38.2） g/L（58.3 ± 10.2） mg/L, the control group were（130.5 ±48.3） g/L,（91.6 ±18.3） mg/L, was statistically significant between two groups（P〈0.05）, the test group compared with control group, the incidence of complications was significantly lower（P〈0.05）. 4.4% and 20% respectively. Conclusion For ACC patients, LC can promote the recovery of gastrointestinal function, improve the inflammatory factor and reduce the incidence rate of complications. It is safe and reliable.

关 键 词：疗效 急性结石性胆囊炎 开腹 腹腔镜 

分 类 号：R722[医药卫生—儿科]