腹腔镜胆囊切除术治疗老年急性化脓性胆囊炎的临床效果  

Clinical Effect of Laparoscopic Cholecystectomy in the Treatment of Acute Suppurative Cholecystitis in the Elderly

作　　者：王涛 赵永 魏胜 WANG Tao;ZHAO Yong;WEI Sheng(Wuxi Rehabilitation Hospital,Wuxi 214000,China;不详)

机构地区：[1]无锡市康复医院,江苏无锡214000

出　　处：《中外医学研究》2023年第34期51-54,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究腹腔镜胆囊切除术治疗老年急性化脓性胆囊炎的临床效果。方法:回顾性分析2015年1月—2021年10月无锡市康复医院收治的68例老年急性化脓性胆囊炎患者的临床资料。根据不同的手术方法将其分为腔镜组(n=38)及开腹组(n=30)。腔镜组采用腹腔镜胆囊切除术,开腹组采用开腹胆囊切除术。比较两组围手术期指标,术前、术后1 d肝功能及应激指标,并发症。结果:腔镜组手术时间、住院时间均短于开腹组,肛门首次排气时间、首次排便时间均早于开腹组,术中出血量、术后引流量均少于开腹组,差异有统计学意义(P<0.05)。术后1 d,两组丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、总胆红素(total bilirubin,TBIL)水平均高于术前,腔镜组ALT、AST、TBIL水平均低于开腹组,差异有统计学意义(P<0.05)。术后1 d,两组超氧化物歧化酶(superoxide dismutase,SOD)水平低于术前,丙二醛(malondialdehyde,MDA)水平高于术前,腔镜组SOD水平高于开腹组,MDA水平低于开腹组,差异有统计学意义(P<0.05)。腔镜组并发症发生率低于开腹组,差异有统计学意义(P<0.05)。结论:老年急性化脓性胆囊炎患者应用腹腔镜胆囊切除术具有创伤小、术中出血量少、住院时间短、并发症少等优势,且对患者肝功能造成的损伤较小,可减轻应激反应,安全性高。Objective:To explore the clinical effect of laparoscopic cholecystectomy in the treatment of acute suppurative cholecystitis in the elderly.Method:The clinical data of 68 elderly patients with acute suppurative cholecystitis admitted to Wuxi Rehabilitation Hospital from January 2015 to October 2021 were retrospectively analyzed.They were divided into endoscopic group(n=38)and laparotomy group(n=30)according to different surgical methods.Laparoscopic cholecystectomy and open cholecystectomy were performed in endoscopic group and laparotomy group.Perioperative indexes,liver function and stress indexes before and 1 d after surgery,and complications were compared between the two groups.Result:The operation time and hospital stay in the endoscopic group were shorter than those in the laparotomy group,the first anal exhaust time and first defecation time were earlier than those in the laparotomy group,and the intraoperative blood loss volume and postoperative drainage volume were less than those in the laparotomy group,the differences were statistically significant(P<0.05).One day after surgery,the alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)levels in the two groups were higher than those before surgery,the levels of ALT,AST and TBIL in endoscopy group were lower than those in laparotomy group,the differences were statistically significant(P<0.05).One day after surgery,the levels of superoxide dismutase(SOD)in the two groups were lower than those before surgery,and the levels of malondialdehyde(MDA)were higher than those before surgery,and the level of SOD in the endoscopy group was higher than that in the laparotomy group,and MDA was lower than that in the laparotomy group,the differences were statistically significant(P<0.05).The incidence of complications in endoscopy group was lower than that in laparotomy group,and the difference was statistically significant(P<0.05).Conclusion:The application of laparoscopic cholecystectomy in elderly patients with acute suppurative cholecys

关 键 词：老年 急性化脓性胆囊炎 腹腔镜胆囊切除术 开腹胆囊切除术 围手术期指标 并发症 

分 类 号：R657.41[医药卫生—外科学]