急诊腹腔镜胆囊切除术与开腹胆囊切除术的临床对比

Clinical Comparison Between Laparoscopic Cholecystectomy and Open Cholecystectomy

目的对比开腹胆囊切除术与腹腔镜胆囊切除术对于胆囊结石的治疗效果。方法整群选择该院2012年6月—2014年12月收治的胆囊结石患者160例为研究对象,根据手术方法将其分为腹腔镜手术组(89例)与开腹手术组(71例),对比两组的术中及术后情况。结果术中情况方面,腹腔镜组的平均手术用时、术中出血量均低于开腹术组,差异均有统计学意义(P<0.05);术后情况方面,开腹术组的住院费用高于腹腔镜组、住院时间、疼痛时间、止痛药用量、下床活动时间、恢复肠道功能时间、引流管拔出时间等均高于腹腔镜组,差异有统计学意义(P<0.05);并发症方面,腹腔镜组的并发症发生总率为4.4%,而开腹术为25.4%,二者比较χ2=6.62,P<0.05,且前者的呼吸道感染、腹腔感染、切口感染率均显著低于开腹术组(P<0.05)。结论腹腔镜技术作为一种新型的微创技术,较之于开腹胆囊切除术,具有切口小、手术时间短、疼痛减轻、促进患者恢复、节约治疗费用、缩短住院时间的优点。

Objective To compare the effect between open cholecystectomy and laparoscopic cholecystectomy for treatment of gallstones. Methods 160 patients with gallstones admitted in our hospital between June 2012 and December 2014 were selected as the research object and divided into laparoscopic surgery group （89 cases） and laparotomy group （71 cases）. Intraoperative and postoperative conditions of the two groups were compared. Results There were statistically significant differences between the in-traoperative conditions, such as average operative duration, the blood loss, of the laparoscopic surgery group which were lower and those of the laparotomy group （P〈0.05）;the postoperative conditions, such as hospitalization expenses, length of stay, time of pain, analgesic dosages, ambulation time, recovery time of bowel function, drainage tube pulled out of time, of the laparotomy group were higher than those of the laparoscopic surgery group, and the differences were statistically significant （P〈0.05）;in terms of complica-tions, the overall incidence of the laparoscopic surgery group, 4.4%, and that of laparotomy group was 25.4%, and the difference was statistically significant （χ2=6.62, P〈0.05）, and the occurring rate of respiratory infections, abdominal infections, wound infection of laparoscopic surgery group were significantly lower than that of the laparotomy group （P〈0.05）. Conclusion Compared to open cholecystectomy, the laparoscopic technique, as a new minimally invasive technique, has the advantages of small incision, shorter operative time, pain relief, quick recovery, low cost and short hospital stay.