腹腔镜技术治疗急性胆囊炎的临床分析

Clinical analysis of laparoscopic techonology in treatment of acute cholecystitis

目的探讨腹腔镜技术治疗急性胆囊炎的临床效果。方法选择2010年1月~2014年12月在我院治疗的急性胆囊炎患者84例的临床资料进行回顾性分析。根据患者的治疗方法分为腹腔镜组44和开腹组40例。腹腔镜组采用腹腔镜手术治疗,开腹组采用开腹手术治疗,比较两组的临床疗效。结果腹腔镜组的术中出血量显著少于开腹组,术后镇痛率显著低于开腹组,术后3 d内的体温显著低于开腹组,术后24 h内进食比例显著高于开腹组,手术时间、住院时间显著短于开腹组,差异有统计学意义（P〈0.01）。两组的引流管放置率比较差异无统计学意义（P〉0.05）。不同手术时机：腹腔镜组的术中出血量少于开腹组,手术时间、住院时间短于开腹组（P〈0.01）。腹腔镜组48 h内手术患者,手术时间、住院时间最短,术中出血量最少（P〈0.01）。两组的术后并发症发生率比较差异无统计学意义（P〉0.05）。结论与传统开腹手术比较,腹腔镜胆囊切除术能够促进术后恢复,缩短住院时间,对患者创伤小,且手术时机越早,患者术后恢复越快。

Objective To discuss clinical effect of laparoscopic techonology in treatment of acute cholecystitis. Methods Clinical data of 84 cases with acute cholecystitis from January 2010 to December 2014 were respectively analyzed.All cases were divided into laparoscopic group（44 cases） and laparotomy group（40 cases） according to operation method.Laparoscopic group was treated with laparoscope,and laparotomy group was treated with laparotomy.Clinical efficacy between two group was compared. Results Bleeding amount during operation in laparoscopic group was obviously less than that of laparotomy group,analgesic rate after operation was obviously lower than that of laparotomy group,the body temperature in 3 days after operation was obviously lower than that of laparotomy group,feeding rate after 24 h operation was obviously higher than that of laparotomy group,operative time and hospital stay was obviously shorter than that of laparotomy group respectively（P〈0.01）.Different operation opportunity：bleeding amount during operation in laparoscopic group was less than that of laparotomy group,operative time and hospital stay was shorter than that of laparotomy group respectively（P〈0.01）.In laparoscopic group,operative time,hospital stay of cases with surgery within 48 h were shortest,and blood loss was least（P〈 0.01）.The complication rate after operation between two groups showed no significant difference（P〉0.05）. Conclusion Compared with traditional laparotomy surgery,laparoscopic cholecystectomy can promote postoperative recovery,shorten hospital stay with less trauma,and the earlier timing of surgery,the faster is postoperative recovery in patients.