常规手术与腹腔镜微创手术治疗胆囊结石的安全性及预后分析

Analysis the safety and prognosis of routine surgery and laparoscopic minimally invasive surgery in patients with cholecystolithiasis

目的探讨常规手术与腹腔镜微创手术治疗胆囊结石的安全性及预后差异,为临床胆囊结石的手术治疗提供指导依据。方法随机将本院收治的114例胆囊结石患者分为微创组(60例)和常规组(54例)。微创组患者采取双镜联合微创手术治疗,常规组患者采取开腹手术治疗,比较两组患者术中术后情况、疗效及术后并发症发生情况。结果微创组患者手术时间显著长于常规组,术中出血量、术后24小时白细胞含量及体温、术后胃肠排气时间、住院时间均显著低于常规组,差异均具有显著性(P<0.05);两组患者住院费用、腹腔引流时间比较差异均无显著性(P>0.05)。微创组患者治疗总有效率为96.7%(58/60),常规组为98.1%(53/54),两组比较差异无显著性(P>0.05)。微创组患者术后并发症发生率为8.3%(5/60),常规组为14.8%(8/54),两组比较差异无显著性(χ2=1.182,P=0.277)。结论腹腔镜微创手术治疗胆囊结石临床效果与常规手术无差异,但腹腔镜微创手术可明显减少术中出血量、术后发热等不良反应,同时不会增加术后并发症发生率,促进患者病情恢复,提高其生活质量,值得临床推广应用。

Objective To explore the difference of the safety and prognosis effect between the routine surgery and laparoscopic minimally invasive surgery for patients with cholecystolithiasis, provide method guidance for clinical treatment. Method 114 patients with cholecystolithiasis were divided into minimally invasive group （60 cases） and routine group （54 cases）. Minimally invasive group were treated by endoscopy combined with minimally invasive surgery, routine surgery group used open operation; two groups were compared in traoperativepostoperative situation, curative effects and adverse reactions. Result The surgery time in minimally invasive group was signiifcantly longer than routine group, the blood loss, postoperative 24 hours leukocyte content and temperature, postoperative gastrointestinal exhaust time, length of hospital stay in minimally invasive group were signiifcantly lower than routine group, the differences were statistically signiifcant （P 0.05）. Minimally invasive group with total effective rate was 96.7%（58/60）, routine group was 98.1%（53/54）, the difference was not significant （P 〉 0.05）. Postoperative complications occurred in minimally invasive group was 8.3%（5/60）, 14.8%（8/54） in routine group, the difference was not signiifcant （χ2=1.182, P=0.277）. Conclusion Laparoscopic minimally invasive surgery for cholecystolithiasis clinical effect has no difference with routine surgery, but laparoscopic minimally invasive surgery can significantly reduce blood loss, postoperative fever and other adverse reactions, but does not increase the incidence of postoperative complications and improve the quality of life of patients, it is worth clinical application.