电视腹腔镜胆囊切除术与开腹胆囊切除术治疗结石性胆囊炎的效果对比研究

Comparative study on efficacy of television laparoscopic cholecystectomy and open cholecystectomy for the treatment of calculous cholecystitis

目的 分析腹腔镜下手术治疗结石性胆囊炎急性发作的临床疗效.方法 回顾性分析某院2009年1月至2013年6月收治的急性结石性胆囊炎患者的临床资料.结果 实验组患者心率[（85±9）次/min]、收缩压[（119±19）mmHg]、呼吸频率[（24±5）次/min],与对照组心率[（89±11）次/min]、收缩压[（121±20）mmHg]、呼吸频率[（24±5）次/min]比较差异无统计学意义（P＞0.05）.实验组术中出血[（62.27±5.22） ml]、术中时间[（56.78±7.69）min]、下床活动时间[（9.64±2.47）h]、住院总天数[（4.01±1.64）d]与对照组术中出血[（115.23±8.72）ml]、术中时间[（72.34±12.56）min]、下床活动时间[（21.20±3.65）h]、住院总天数[（10.34±2.31）d]比较差异有统计学意义（P＜0.05）.实验组并发胆管损伤1例、胆心反射1例,对照组并发肠粘连3例、感染2例、胆管损伤4例、出血2例、胆心反射3例,实验组并发例数明显少于对照组,两组比较差异具有统计学意义（P＜0.05）.结论 腹腔镜胆囊切除术治疗结石性胆囊炎急性发作,手术创伤小,术后恢复快,并发症发生率低,可在临床中推广使用.

Objective To analyze the clinical curative effect of laparoscopic surgery in the treatment of calcnlous cholecystitis acute attack.Methods A retrospective analysis was carried out to study the clinical data of patients with acute calculous cholecystitis admitted in our hospital from January 2009 to June 2013.Results The experimental group patients had heart rate of （85 ± 9） times/min,systolic blood pressure of （119 ± 19） mmHg,respiratory frequency of （24 ± 5） times/min,and the control group were （89 ± 11） beats/min,systolic blood pressure （121 ± 20） mmHg,respiratory frequency （24 ± 5） times/min,there was no statistical significant difference （P ＞ 0.05）.Experimental group had intraoperative bleeding of （62.27 ± 5.22） ml,intraoperative time of （56.78 ± 7.69） min,ambulation time of （9.64 ± 2.47） h,the length of the total number of days was （4.01 ± 1.64） and the control group were intraoperative bleeding （115.23 ± 8.72） ml,intraoperative time （72.34 ± 12.56） min,ambulation time （21.20 ± 3.65） h,the length of the total number of days （10.34 ± 2.31）d,two groups showed statistically significant difference （P ＜ 0.05）.Experimental group had 1 case complicated with bile duct injury,bravery heart reflection example,the control group had intestinal adhesion （3 cases）,infection in 2 cases,4 cases of bile duct injury,hemorrhage in 2 cases,bravery heart reflected in 3 cases,the number of concurrent cases in the experimental group was significantly fewer than that of the control group,showing statistical significant difference （P ＜ 0.05）.Conclusion Laparoscopic cholecystectomy in the treatment of calculous cholecystitis acute episodes has advantages of small surgical trauma,quicker recovery,low incidence of complications,which can be used widely in clinic.