腹腔镜胆囊切除术治疗急性结石性胆囊炎的手术时机与疗效研究  

Study on the Operation Time and Curative Effect of Laparoscopic Cholecystectomy in the Treatment of Acute Calculous Cholecystitis

作　　者：孙斌 金圣杰[2] SUN Bin;JIN Sheng-jie(Department of General Surgery,Yangzhou Second People’s Hospital,Yangzhou,Jiangsu Province,225007 China;Department of Hepatobiliary and Pancreatic Surgery,North Jiangsu People’s Hospital,Yangzhou,Jiangsu Province,225000 China)

机构地区：[1]江苏省扬州市第二人民医院普外科,江苏扬州225007 [2]江苏省苏北人民医院肝胆胰外科,江苏扬州225000

出　　处：《中外医疗》2018年第8期62-64,共3页China & Foreign Medical Treatment

摘　　要：目的分析急性结石性胆囊炎患者采用腹腔镜胆囊切除术治疗的手术时机以及手术疗效。方法方便选取该院和江苏省苏北人民医院2014年1月—2017年12月期间收治的106例采用腹腔镜胆囊切除术治疗的急性结石性胆囊炎患者采用随机双色球法随机分为治疗组(53例,患者发病72 h内实施手术)和对照组(53例,患者发病72 h后实施手术),对比两组患者手术相关指标、住院时间以及术后并发症发生率、复发率。结果治疗组患者术中出血量(40.0±10.2)m L、手术时间(59.1±11.2)min、术后肛门排气时间(30.2±3.2)h、住院时间(3.9±3.6)d与对照组比较差异有统计学意义(t=4.23,5.09,6.21,4.72,P<0.05)。治疗组并发症发生率(3.8%)显著低于对照组(18.9%)差异有统计学意义(χ~2=4.03,P<0.05)。治疗组患者复发率(1.9%)显著低于对照组(7.5%)差异有统计学意义(χ~2=4.01,P<0.05)。结论急性结石性胆囊炎患者采用腹腔镜胆囊切除术治疗的最佳手术时机是在发病72 h内,有利于减少术中出血量,降低患者术后并发症发生率,缩短患者住院时间,减少术后复发。Objective To analyze the operation time and curative effect of laparoscopic cholecystectomy in the treatment of acute calculous cholecystitis.Methods 106 cases of acute cholecystitis treated by laparoscopic cholecystectomy in our hospital and North Jiangsu People’s Hospital from January 2014 to December 2017 were randomly divided into treatment group(53 cases,surgery in 72h)and control group(53 cases,surgery after 72 h),and the surgery related indicators,length of stay and incidence rate of postoperative complications,recurrence rate were compared between the two groups.Results The intraoperative bleeding volume(40.0±10.2)mL,operation time(59.1±11.2)min,postoperative anus exhaust time(30.2±3.2)h,length of stay(3.9±3.6)d were significantly lower than those in the control group,the difference was significant(t=4.23,5.09,6.21,4.72,P<0.05).The complication rate in the treatment group(3.8%)was significantly lower than that in the control group(18.9%),the differeence was statiscally significant(χ2=4.03,P<0.05).The recurrence rate(1.9%)in the treatment group was significantly lower than that in the control group(7.5%)the differeence was statiscally significant(χ2=4.01,P<0.05).Conclusion The best operation time of acute cholecystitis treated by laparoscopic cholecystectomy is within 72 h after onset,which is conducive to reducing intraoperative bleeding,reducing the incidence of postoperative complications,shortening the length of stay and reducing the recurrence rate after surgery.

关 键 词：急性结石性胆囊炎 腹腔镜胆囊切除术 手术时机 手术疗效 

分 类 号：R657[医药卫生—外科学]