腹腔镜手术与开腹手术治疗胆囊结石的临床分析

Clinical analysis of laparoscopic surgery and open surgery for gallstones

目的观察腹腔镜胆囊切除术（Lc）与开腹胆囊切除术在临床上治疗胆囊结石的疗效，为基层医院治疗胆囊结石的手术方式提供更好的选择。方法选取在鄢陵县人民医院住院的86例胆囊结石患者，并随机分为两组，腹腔镜组（Lc组）43例在腹腔镜下行胆囊切除术，开腹组（OC组）43例行开腹胆囊切除术。比较两组患者手术后临床效果及术后并发症的情况。结果①两组患者手术平均时间、术中出血量比较差异有统计学意义（P〈0．05）；②两组术后胃肠道恢复正常排气时间、排便时间、术后抗茵药物使用时间、术后平均住院日及并发症的发生率比较，差异均有统计学意义（P〈0．05）。结论腹腔镜下行胆囊切除术临床效果较为明显，与开腹胆囊切除术相比，具有对患者创伤较小、安全系数相对较高、术中平均出血量相对较少、术后恢复相对较快、住院时间较短、术后并发症发生率低等优点，值得临床基层医院大力推广。

Objective To observe the effects of !aparoscopic cholecystectomy ! LC ） and open choleeystectomy on gallstones, and provide better choice for operation method of gallstones in basic hospi- tal. Methods Eighty-six cases of gallstone were selected in Yanling people＇ s hospital, and were ran- domly divided into two groups. The 43 cases in laparoscopic group （LC group） underwent laparoscopic cholecystectomy, and the 43 cases in the open surgery group （OC group） underwent open cholecystecto- my. The clinical efficacy and postoperative complications of the two groups were compared after surgery. Results （1）There were significant differences in the average surgery time and blood loss between the two groups（P 〈 0. 05 ）. （2）There were significant differences in postoperative gastrointestinal exhaustion re- covery time, defecation time, postoperative antibiotics usage time, the postoperative average hospital stay and the incidences of eoniplications between the two groups （P 〈 0. 05 ）. Conclusions Compared with open cholecystectomy, the effect of laparoscopic cholecystectomy is better, and ithas the advantages of little surgical trauma, safe, less intraoperative average blood loss, rapid postop6ra- tive recovery, shorter hospital stay, low postoperative complication incidence, and is worthy to be vigor- ously promoted in grass-roots hospitals.