腹腔镜胆囊切除术治疗急性胆囊炎并发胆结石的安全性及预后评估分析  

Analysis of Safety and Prognosis Evaluation of Laparoscopic Cholecystectomy in the Treatment of Acute Cholecystitis Complicated with Cholelithiasis

作　　者：汪威[1] 聂颖[2] 朱立东[1] WANG Wei;NIE Ying;ZHU Lidong(Puren Hospital,Beijing 100062,China;不详)

机构地区：[1]北京市普仁医院,北京100062 [2]北京市中日友好医院

出　　处：《中国医学创新》2020年第16期56-59,共4页Medical Innovation of China

基　　金：北京市东城区科技计划项目(2017-5-004)。

摘　　要：目的:分析腹腔镜胆囊切除术治疗急性胆囊炎并发胆结石的安全性及预后情况.方法:选择2016年9月-2019年9月于本院接受治疗的80例急性胆囊炎并发胆结石患者为研究对象.按照就诊顺序,将其随机分为对照组和观察组,每组40例.对照组应用开腹胆囊切除手术,观察组应用腹腔镜胆囊切除术.比较两组住院时长、术中出血量以及手术时长、术后情况以及并发症发生情况.结果:观察组手术时长、住院时长均短于对照组,术中出血量低于对照组,差异均有统计学意义(P<0.05).观察组并发症发生率为10.00%,明显低于对照组的40.00%,差异有统计学意义(P<0.05).观察组排气时长、疼痛持续时长及引流管留置时长均短于对照组,差异均有统计学意义(P<0.05).结论:对于急性胆囊炎合并胆结石患者来讲,利用腹腔镜下胆囊切除术能够取得满意效果.此法安全性强、有效性高.可以降低术中出血发生率,缩短引流管留置时间、肛门排气时间及疼痛持续时长,因此值得进一步推广.但开展此类手术之前,必须确定患者的手术适应证.且要以保证手术安全为基础,同时也要依靠临床医生的精湛技术水平以及临床经验.只有这样,才能够更好地突显出来腹腔镜手术的优势.Objective:To analyze the safety and prognosis of laparoscopic cholecystectomy in the treatment of acute cholecystitis complicated with cholelithiasis.Method:A total of 80 patients with acute cholecystitis complicated with cholelithiasis who were treated in our hospital from September 2016 to September 2019 were selected as the study subjects.According to the order of visit,they were randomly divided into control group and observation group,with 40 cases in each group.The control group received open cholecystectomy,the observation group underwent laparoscopic cholecystectomy.The duration of hospitalization,intraoperative blood loss,duration of operation,postoperative status and complications of the two groups were compared.Result:The duration of surgery and hospitalization in the observation group were shorter than those of the control group,and the amount of intraoperative blood loss was lower than that of the control group,with statistically significant differences(P<0.05).The incidence of complications in the observation group was 10.00%,significantly lower than 40.00%in the control group,the difference was statistically significant(P<0.05).The duration of exhaust,pain and drainage tube indwelling in the observation group were shorter than those in the control group,with statistically significant differences(P<0.05).Conclusion:For patients with acute cholecystitis and cholelithiasis,laparoscopic cholecystectomy can achieve satisfactory results.This method is safe and effective.It can reduce the incidence of intraoperative bleeding,shorten the drainage tube indwelling time,anal exhaust time and the duration of pain,so it is worth further promotion.But before such an operation can be performed,the patient’s surgical indications must be determined.And to ensure the safety of surgery as the basis,but also to rely on the skilled level of the clinician and clinical experience.Only in this way can the advantages of laparoscopic surgery be better highlighted.

关 键 词：腹腔镜 胆囊切除术 急性胆囊炎 胆结石 安全性 

分 类 号：R657.4[医药卫生—外科学]