腹腔镜治疗急性坏疽性胆囊炎疗效及危险因素分析

Curative effect of laparoscope in treatment of acute gangrenous cholecystitis and its risk factors

目的:探讨腹腔镜治疗急性坏疽性胆囊炎的临床疗效及危险因素。方法:回顾性分析在我院行腹腔镜手术治疗的89例急性胆囊炎患者临床资料。结果:急性坏疽性胆囊炎患者共20例,占腹腔镜急性胆囊炎手术患者22.47%,治愈率100.00%;急性坏疽性胆囊炎患者治疗前碱性磷酸酶(AKP)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)与治疗后比较差异具有统计学意义(P<0.05);单因素分析显示AKP、ALT、AST、TBIL、白细胞计数、胆囊壁厚度是与坏疽性胆囊炎发生相关的危险因素(P<0.05)。结论:腹腔镜治疗急性坏疽性胆囊炎临床疗效较为满意,较为安全,高年龄、存在合并症、体温升高、白细胞计数升高及胆囊壁明显增厚均为坏疽性胆囊炎的危险因素,要及时制定合理治疗方案进行治疗,降低急性坏疽性胆囊炎的病死率。

Objective： To investigate curative effect of laparoscope in treatment of acute gangre- nous cholecystitis and its risk factors. Methods：Clinical data of 89 cases withacute cholecystitis were retro- spective analyzed in January 2005-2011. Results： There were 20 cases with acute gangrenous cholecystitis （22.47%）, the cure rate was 100.00% alkaline phosphatase （AKP）, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, total bilirubin （TBIL） were significantly improved after surgery （P~ 0.05） ~ Single factor analysis showed that AKP, ALT, AST, TBIL, white blood cell count, gallbladderwall thickness iand gangrenous cholecystitis were r risk factors （P^O. 05）. Conclusions： Laparoscopic treatment is satisfactory and safe for acute gangrenous cholecystitis. Age, complications, increased body temperature, increase white blood cell count and thickening gallbladder wall are risk factors of gangrenous cholecystitis. Timely and rational treatment can reduce the mortality.