急性胆囊炎腹腔镜手术时机选择与预后的相关性分析

Opportunity and prognostic of laparoscopic cholecystectomy for acute cholecystitis

目的研究手术时机的选择对急性胆囊炎腹腔镜手术效果和患者预后的影响。方法本院2008～2011年收治的340例急性胆囊炎患者根据病程分为实验组(72h内早期手术)和对照组(早期抗感染处理72h后延期手术),对两组患者的中转率、手术时间、住院时间及术后并发症等进行观察和对比。结果实验组手术中转开腹10例(5.21%),手术时间(49.6±15.4)min,住院时间(7.2±3.1)d,对照组手术中转开腹14例(9.46%),手术时间(67.6±18.7)min,住院时间(13.6±4.3)d。实验组发生肺部感染、肠梗阻、局部感染等并发症8例(4.17%),对照组发生肺部感染、肠梗阻、局部感染、胆汁漏等并发症11例(7.43%)。实验组患者中转率、手术时间、住院时间、并发症率等均显著低于对照组(P<0.05)。结论早期腹腔镜手术能降低中转率,缩短手术时间和住院时间,减少并发症,减轻患者痛苦,对于急性胆囊炎有更好疗效。

Objective To study the relativity of prognostic and opportunity of laparoscopic cholecystectomy（LC） for acute cholecystitis. Methods Three hundred and forty cases of patients with acute cholecystitis from 2008 to 2011 were divided into experimental group（operation in 72 h） and control group（early anti-infection treatment and operation after 72 h） ,the transference rate, operation time and hospital stay time were observed. Results The experimental group transferred to laparotomy were 10 cases （5.21%）, the operative time was （49.6±15.4） min, the hospital stay time was（7.2±3.1） d, in control group,14 patients （9.46%） transferred to laparotomy, the operation time was （67.6±18.7）min, the hospital stay time was （13.6±4.3） d. Lung infections, intestinal obstruction, local infection and other complications occured in 8 cases （4.17%） of the experimental group, 11 cases （7.43%） of the control group. The transference rate, operation time and hospital stay time, complication rates of the experimental group are significantly better than the control group （P 0.05）. Conclusion The prophase LC can reduces the transference rate, shortens operation time and hospital stay time and reduces the complications and patients＇ pain, is effective for acute cholecystitis.