腹腔镜胆囊切除治疗轻症急性胆源性胰腺炎的临床研究  

Clinical Study of Laparoscopic Cholecystectomy in the Treatment of Acute Biliary Pancreatitis

作　　者：卜迟文[1] 杨全德[1] 张冬[1] BU Chiwen;YANG QuANDe;ZHANG Dong(People＇s Hospital of Guanyun,Guanyun 222200,China)

机构地区：[1]灌云县人民医院,江苏灌云222200

出　　处：《中外医学研究》2018年第29期15-16,共2页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨腹腔镜胆囊切除治疗轻症急性胆源性胰腺炎的可行性。方法:回顾性分析2016年1月-2018年1月在笔者所在医院住院的51例因胆囊结石致轻症胆源性胰腺炎患者的临床资料。按手术时机不同分为三组(1组、2组、3组),1组22例在病情平稳48 h内行腹腔镜胆囊切除术;2组11例在保守治疗平均4 d复查血淀粉酶接近正常行腹腔镜胆囊切除术;3组18例患者经保守治疗好转后6周左右来院行腹腔镜胆囊切除术。分析三组患者血液学及临床指标情况。结果:1组和2组总住院时间、手术难易程度与3组比较,差异有统计学意义(P<0.05);1组术后第3天血淀粉酶下降,与手术前比较,差异有统计学意义(P<0.05)。三组平均手术时间、中转开腹及术后并发症比较,差异无统计学意义(P>0.05)。结论:对于轻症急性胆源性胰腺炎患者早期(48 h内)和先行保守治疗复查血淀粉酶接近正常时(平均在治疗后第4天)行腹腔镜胆囊切除术均可得到满意的治疗效果,对于基层医院值得推广应用。Objective：To investigate the feasibility of laparoscopic cholecystectomy for the treatment of acute biliary pancreatitis.Method：The clinical data of 51 patients hospitalized in our hospital from January 2016 to January 2018 were analyzed retrospectively.They were divided into three groups（Group 1,2,3） on the basis of operation time.In Group 1,22 patients underwent laparoscopic cholecystectomy in 48 hours.In Group 2,11 patients were treated with blood amylase close to normal laparoscopic cholecystectomy on an average of 4 days.In Group 3,18 patients underwent laparoscopic cholecystectomy for about 6 weeks, conservative treatment.The hematology and clinical indicators of three groups were analyzed.Result：Compared with Group 3,Group 1 and Group 2 had statistically significant difference in total hospitalization duration and degree of operative difficulty（P〈0.05）.The decrease of blood amylase in Group 1 was statistically significant than before treatment（P〈0.05）.There was no statistically significant differences between the three groups in the average operative time and postoperative complications.Conclusion：The curative effect of laparoscopic cholecystectomy of patients with acute gallstone pancreatitis（in 48 hours） and the first review of conservative treatment of blood amylase near normal line average（4 days） are good.It is worth popularizing and applying for basic-level hospital.

关 键 词：腹腔镜胆囊切除术 急性胆源性胰腺炎 胆囊结石 

分 类 号：R657.4[医药卫生—外科学]