腹腔镜与传统开腹式治疗急性胆囊炎的临床效果对比分析

Comparative Analysis of the Clinic Effect Between Laparoscopic Cholecystectomy and Open Cholecystectomy on Acute Cholecystitis

目的比较分析腹腔镜与传统开腹术治疗急性胆囊炎的临床效果。方法收集该院收治的524例急性胆囊炎患者资料作为分析对象,其中285例行腹腔镜胆囊切除术,239例行传统开腹胆囊切除术。比较两组患者的术中指标:如切口长度、术中出血量、术中引流量、手术时间;术后各项恢复指标,如肠鸣音恢复时间、疼痛视觉模拟评分、止痛药使用例数、术后下床时间和住院时间;以及并发症情况。结果腹腔镜胆囊切除术治疗急性胆囊炎的术中各项指标:切口长度、术中出血量、术中引流量、手术时间分别为(3.5±0.7)cm,(45.2±8.4)mL,(63.8±12.9)mL,(52.7±15.3)mL,均低于于传统开腹胆囊切除术的(11.2±2.7)cm,(89.1±16.6)mL,(97.6±14.2)mL,(85.1±14.6)mL;两组间差异有统计学意义(P<0.05)。同时,术后各项恢复指标,如肠鸣音恢复时间、疼痛评分、止痛药使用例数、术后下床时间和住院时间分别为(23.2±3.5)h,(2.3±0.6)分,203例,(27.1±4.2)h,(5.0±1.5)d,差异有统计学意义(P<0.05)低于于传统开腹胆囊切除术的(43.6±6.8)h,(4.7±1.4)h,236例,(48.3±7.5)h,(12.5±4.0)d。同时,腔镜胆囊切除术患者的并发症发生率(3.5%)显著低于传统开腹式(11.3%)(P<0.05)。结果腹腔镜胆囊切除术治疗急性胆囊炎的术中各项指标、术后各项恢复指标均显著优于传统开腹胆囊切除术(P<0.05)。同时,腔镜胆囊切除术患者的并发症发生率显著低于传统开腹式(P<0.05)。结论腹腔镜胆囊切除术是一种治疗急性胆囊炎的安全、有效的手术方式,值得在临床上推广。

Objective To compare and analyze the clinic effect between laparoscopic cholecystectomy and open cholecystectomy on acute cholecystitis. Methods The clinical data of 524 patients with acute cholecystitis admitted in our hospital were collected for analysis, of whom, 285 cases of patients underwent laparoscopic cholecystectomy, and 239 cases of patients underwent tradi-tional open cholecystectomy. The intraoperative indicators including length of incision, intraoperative bleeding volume, intraopera-tive drainage, operation time; postoperative indicators such as the recovery time of bowel sound, visual analogue score, the number of patients using painkillers, postoperative ambulation time, hospitalization duration, and postoperative complications were com-pared between two groups. Results The intraoperative indicators such as the length of incision, intraoperative bleeding volume, in-traoperative drainage and operation time of the patients underwent laparoscopic cholecystectomy were （3.5±0.7）cm, （45.2±8.4） mL, （63.8±12.9） mL, （52.7±15.3） mL respectively, and which was lower than （11.2±2.7） cm, （89.1±16.6） mL, （97.6±14.2） mL, （85.1±14.6） mL of the patients underwent traditional open cholecystectomy, separately, there were statistically significant differences between the two groups（P〈0.05）. Postoperative indicators such as the recovery time of bowel sound, visual analogue score, the num-ber of patients using painkillers, postoperative ambulation time, hospitalization duration of the patients underwent laparoscopic cholecystectomy, were （23.2±3.5） h, （2.3±0.6） points, 203 cases,（27.1±4.2） h,（5.0±1.5） d, significantly lower than 43.6±6.8 h, 4.7±1.4 h, 236 cases, （48.3±7.5） h, （12.5±4.0） d of patients underwent traditional open cholecystectomy（P〈0.05）. Meanwhile, the incidence of postoperative complications （3.5%） was significant lower than that （11.3%） of patients underwent traditional open cholecystectomy （P〈0.05）. Results For acute cholecystitis, the intraoperative indicators and postoperative indicators of laparo-scopic cholecystectomy were all significantly better than those of the traditional open cholecystectomy （ P〈0.05）, and the incidence of complications was obviously lower than that of traditional open cholecystectomy （ P〈0.05）. Conclusion Laparoscopic cholecystec-tomy is a safe and effective modus for acute cholecystitis, it is deserved to be promoted in clinical practice.