急性非结石性胆囊炎42例诊治分析  

Diagnosis and treatment of 42 cases of acute acalculous cholecystitis

作　　者：邵得志 冯志毅 郭乃超 吕衍霖 王晓翠 董宇豪 Shao Dezhi;Feng Zhiyi;Guo Naichao;Lvy Yanlin;Wang Xiaocui;Dong Yuhao(Department of General Surgery,The 982th military Hospital,Tangshan 063000,China)

机构地区：[1]中国人民解放军联勤保障部队第982医院普通外科,河北唐山063000

出　　处：《中华普外科手术学杂志（电子版）》2021年第4期434-436,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然科学基金项目(81871317)。

摘　　要：目的探讨急性非结石性胆囊炎(AAC)的不同手术时机的临床意义。方法回顾性分析2015年1月至2020年1月行腹腔镜手术的42例AAC患者资料。依据ACC发病时间做为时间节点,分为<72 h组(29例)和>72 h组(13例),应用SAS6.12统计软件分析,两组患者术中胆囊病变情况、手术方式、并发病发生率等计数资料进行χ^(2)检验,P<0.05为差异有统计学意义。结果<72 h组患者胆囊病变以水肿、化脓为主;>72 h组胆囊坏死及穿孔比例升高,手术方式以腹腔镜胆囊大部切除术及胆囊造瘘术为主,且术后出血、胆汁漏、腹腔感染、肺部感染、多器官功能衰竭等并发症发生率明显高于<72 h组(P<0.05)。结论宜在AAC发病72 h以内实施手术。Objective To investigate the optimal operation time of acute acalculous cholecystitis(AAC).Methods Retrospectively analyze the data of 42 AAC patients undergoing laparoscopic surgery from January 2015 to January 2020.The patients were divided into the<72 h(29 cases)group and>72 h group(13 cases)according to the onset time of AAC.SAS 6.12 statistical software was used to analyze the data.χ^(2) test was used to analyze the intraoperative gallbladder lesions,surgical methods and postoperative complication rate,P<0.05 was considered statistically significant.Results Edema and suppuration were the main gallbladder lesions in the<72 h group,the proportion of necrosis and perforation increased in the>72 h group,Laparoscopic subtotal cholecystectomy and cholecystostomy were the main surgical methods.The incidence of postoperative complications such as bleeding,bile leakage,abdominal infection,pulmonary infection and multi-organ failure was higher than that in the<72 h group,with statistical significance(P<0.05).Conclusion The operation should be performed within 72 hours after the onset of AAC.

关 键 词：急性非结石性胆囊炎 胆囊切除术 腹腔镜 坏死 手术后并发症 胆囊造口术 

分 类 号：R657.4[医药卫生—外科学]