急性结石性胆囊炎开展腹腔镜手术治疗时机选择对康复效果的影响

Influence of the Timing of Laparoscopic Surgery on the Rehabilitation Effect of Acute Calculous Cholecystitis

目的探讨急性结石性胆囊炎开展腹腔镜手术治疗时机选择对康复效果的影响.方法选取2016年10月—2020年12月固安县人民医院收治的82例急性结石性胆囊炎患者,所有患者均接受腹腔镜手术治疗,按照患者治疗时机的不同将其分为早期组42例与延期组40例.早期组患者在发病后72 h内进行手术,延期组患者在发病后72 h后开展手术治疗.治疗后,对比两组术中出血量、手术时间、肛门排气时间、首次下床活动时间、住院时间,并使用视觉模拟评分法(VAS)评估两组患者术后1、3、5 d的疼痛情况,同时观察两组术后并发症发生情况.结果治疗后,早期组术中出血量少于延期组,且手术时间、肛门排气时间、首次下床活动时间以及住院时间均短于延期组,组间差异有统计学意义(P<0.05).早期组术后1、3、5 d的VAS评分均低于延期组,组间差异有统计学意义(P<0.05).早期组并发症发生率为4.76%,低于延期组的20.00%,差异有统计学意义(P<0.05).结论在发病72 h内为急性结石性胆囊炎患者行腹腔镜手术能有效改善患者手术指标,减轻其术后疼痛,对其后续康复进程有积极意义,且并发症发生风险较低,具有较高临床应用价值.

Objective To investigate the influence of the timing of laparoscopic surgery on the rehabilitation effect of acute calculous cholecystitis.Methods 82 patients with acute calculous cholecystitis who were admitted to Gu'an County People's Hospital from October 2016 to December 2020 were selected.All patients received laparoscopic surgery,and they were divided into 42 cases in an early group and 40 cases in a delayed group according to different treatment timings.The patients in the early group underwent surgery within 72 hours after the onset of the disease,and the patients in the delayed group underwent surgery after 72 hours after the onset of the disease.After treatment,the intraoperative blood loss and operation time,anal exhaust time,first ambulation time,and hospital stay timewere compared between the two groups,the visual analogue scale(VAS)was used to evaluatethe pain status of the two groups at 1,3 and 5 d after surgery,and the occurrence of postoperative complicationswere observed in the two groups.Results After treatment,the amount of intraoperative blood loss in the early group was less than that in the delayed group,and the operation time,anal exhaust time,first ambulation time and hospital stay time were shorter than those in the delayed group,and the differences between the groups were statistically significant(P<0.05).The VAS scores at 1,3 and 5 d after surgery in the early group were lower than those in the delayed group,and the differences between the groups were statistically significant(P<0.05).The complication rates of the early group were 4.76%,which was lower than 20.00%in the delayed group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic surgery for patients with acute calculous cholecystitis within 72 hours of onset can effectively improve the surgical indicators,reduce postoperative pain,and has positive significance for the subsequent rehabilitation process.The risk of complications is low,and it has high clinical application value.