早期与择期腹腔镜胆囊切除术治疗老年急性胆囊炎效果比较  

Early versus elective laparoscopic cholecystectomy in treatment of elderly patients with acute cholecystitis

作　　者：王健 陈诚 柯亮亮 WANG Jian;CHEN Cheng;KE Liangliang(Department of General Surgery,Ruichang City Hospital of Traditional Chinese Medicine in Jiangxi Province,Ruichang,Jiangxi,332200)

机构地区：[1]江西省瑞昌市中医医院普外科,江西瑞昌332200

出　　处：《实用临床医药杂志》2020年第23期36-38,共3页Journal of Clinical Medicine in Practice

基　　金：江西省卫生健康委科技计划项目(20204224)。

摘　　要：目的比较早期与择期腹腔镜胆囊切除术治疗老年急性胆囊炎的临床效果。方法将84例老年急性胆囊炎患者分为早期组(发病72 h内手术)和择期组(发病72~96 h手术),每组42例。比较2组手术时间、术中出血量、术后首次下床活动时间、胃肠功能恢复时间、住院时间、术后腹腔引流量及住院总费用、中转开腹率、术后并发症发生率。结果早期组手术时间、术后首次下床活动时间、胃肠功能恢复时间、住院时间均短于择期组,术中出血量、术后腹腔引流量、住院费用少于择期组,差异均有统计学意义(P<0.05)。早期组中转开腹率为2.38%,低于择期组的21.43%,差异有统计学意义(P<0.05)。早期组并发症发生率为2.38%,低于择期组的19.05%,差异有统计学意义(P<0.05)。结论发病72 h内行腹腔镜胆囊切除术治疗急性胆囊炎的临床效果显著,可缩短手术时间、住院时间,降低中转开腹率和并发症发生率。Objective To compare the clinical effect of early and elective laparoscopic cholecystectomy in the treatment of elderly patients with acute cholecystitis.Methods Totally 84 elderly patients with acute cholecystitis were divided into early group(treated within 72 hours after onset)and selective group(treated from 72 to 96 hours after onset).The operation time,intraoperative blood loss,first time to bed-off activity after operation,recovery time of gastrointestinal function,hospital stay,postoperative abdominal drainage volume and total hospitalization costs,conversion rate to laparotomy and incidence of postoperative complications were compared between the two groups.Results The operation time,the first time to bed-off activity after operation,recovery time of gastrointestinal function and hospital stay of the early group were significantly shorter than those of the selective group,and the intraoperative blood loss,postoperative abdominal drainage volume and hospitalization costs were significantly less than those of the selective group(P<0.05).The conversion rate to laparotomy in the early group was 2.38%,which was significantly lower than 21.43%in the selective group(P<0.05).The incidence of complications in the early group was 2.38%,which was significantly lower than 19.05%in the selective group(P<0.05).Conclusion Laparoscopic cholecystectomy is effective in the treatment of patients with acute cholecystitis within 72 hours after onset,which can shorten the operation time and hospital stay,reduce the conversion rate to laparotomy and the incidence of complications.

关 键 词：腹腔镜胆囊切除术 急性胆囊炎 开腹手术 并发症 手术时机 择期手术 早期手术 

分 类 号：R575.6[医药卫生—消化系统] R61[医药卫生—内科学]