不同时机行腹腔镜胆囊切除术治疗急性结石性胆囊炎的效果及预后  

Effect and prognosis of laparoscopic cholecystectomy for acute cholecystitis

作　　者：邓仲鸣 赵云[1] 

机构地区：[1]湖北医药学院附属襄阳医院,襄阳441000

出　　处：《肝胆外科杂志》2015年第6期418-420,共3页Journal of Hepatobiliary Surgery

摘　　要：目的对不同时机行腹腔镜胆囊切除术治疗急性结石性胆囊炎的疗效以及预后进行探讨。方法依据疾病发作到手术时间的不同把2013年3月到2014年3月在我院接受腹腔镜胆囊切除术的急性结石性胆囊炎患者102例分为A、B、C三组,A组症状发生到手术时间不到48h,共37例;B组症状发生到手术时间在48h到72h之间,共34例;C组症状发生到手术时间超过72 h,共31例。分别对三组各项指标进行观察:包括1手术情况:手术时间、术中出血量、术后疼痛时间、术后肛门排气时间、住院时间;2中转开腹例数;3并发症情况:切口感染、腹腔感染、肺部感染、胆漏等并发症的例数。结果 1 C组的平均术中出血量、平均手术时间、平均术后疼痛时间、平均术后肛门排气时间、平均住院时间均高于A、B两组,具有统计学差异性(P<0.05),B组的各项术中情况亦高于A组,不具有统计学差异性(P>0.05);2 A、B、C三组的中转开腹率分别为,C组的中转开腹率最高,三组的中转开腹率比较差异性有统计学意义(P<0.05),而对A组和B组进行比较分析,两组差异性不具有统计学差异性(P>0.05);3 A、B、C三组的术后并发症发生率分别为,C组的术后并发症发生率最高,但三组之间不具有统计学差异性(P>0.05)。结论腹腔镜胆囊切除术是一种行之有效的治疗急性结石性胆囊炎的方法,疾病发作到手术在72h内疗效及患者的预后较好,对于超过72 h的在手术时应谨慎操作。Objective To investigate the therapeutic effect and prognosis of laparoscopic cholecystectomy for acute cholecystitis. Methods 102 patients with acute cholecystitis who underwent laparoscopic cholecystectomy in our hospital from March 2014 to March 2013 were divided into three groups: B,C,A,A,48 h,37 cases; B group had 34 cases. The symptoms of 72 h group were more than C,and 31 cases had 72 h. Three groups of indicators were observed,including: operation time,intraoperative blood loss,postoperative pain,postoperative anal exhaust time,hospitalization time,and the number of cases of conversion to open surgery. Results the average operation time,average operation time,average operation time,postoperative pain,average length of postoperative pain,postoperative anal exhaust time,average hospitalization time,average length of stay,hospitalization time were higher in C group than in A group( C). The B group was higher than that in B group( P > 0. 05). The C group was significantly higher than that in A group.( B). The A group was significantly different( P < 0. 05). The complication rate was the highest in the C group,but not between the three groups( P > 0. 05). Conclusion laparoscopic cholecystectomy is an effective method for treating acute cholecystitis,and the effect of the disease on 72 h and the prognosis of patients is good,and the operation should be performed with caution.

关 键 词：腹腔镜 急性结石性胆囊炎 不同时机 

分 类 号：R657.41[医药卫生—外科学]