腹腔镜手术治疗急性胆囊炎的应用价值

Application value of laparoscopic surgery in the treatment of patients with acute cholecystitis

目的:探讨与分析腹腔镜手术治疗急性胆囊炎患者的临床应用价值与意义。方法:选取2013年6月至2014年6月收治的116例急性胆囊炎患者,按手术方式将其分为研究组与对照组。对照组行传统开腹胆囊切除术(open cholecystectomy,OC),研究组行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC),对比分析两组患者的临床治疗情况。结果:研究组显效率为79.31%、有效率为17.24%,总有效率为96.55%,两组相比差异无统计学意义(P>0.05);研究组手术时间、胃肠功能恢复时间、肛门排气时间、下床活动时间、总住院时间均显著优于对照组,差异有统计学意义(P<0.01)。研究组切口感染、腹腔感染、胆漏、胆管损伤等并发症发生率(5.17%)明显低于对照组,差异有统计学意义(P<0.05)。研究组术后C反应蛋白水平显著降低,前白蛋白水平显著提高,差异有统计学意义(P<0.01);结论:腹腔镜手术在改善急性胆囊炎患者的相关临床指标、降低不良反应、调节炎症因子水平方面具有一定的临床价值,可作为急性胆囊炎患者的首选治疗方法。

Objective： To probe into the clinical application value and significance of laparoscopic surgery in the treatment of patients with acute cholecystitis. Methods： From Jun. 2013 to Jun. 2014,116 acute cholecystitis patients were selected and divided into study group and control group. The patients in control group were treated with conventional open cholecystectomy. The patients in study group were treated with laparoscopic cholecystectomy. The clinical effects of the patients in two groups were compared and analyzed. Results： The significant effective ratio of study group was 73. 91%,the effective ratio was 17. 24%,the ratio of total efficiency was96. 55%,compared with control group,the differences were not statistically significant（ P〈0. 05）. Compared with control group,in study group the operative time,the gastrointestinal function recovery time,anal exhaust time,ambulation time,total hospital stay were significantly shorter（ P〈0. 01）. Compared with control group,the overall incidence of complications,including incision infection,abdominal infection,bile leakage and bile duct injury in study group（ 5. 17%） was significantly less（ P〈0. 05）. In study group after operation the level of C-reactive protein significantly decreased（ P〈0. 05）,while the levels of prealbumin significantly increased（ P〈0. 01）. Conclusions： Laparoscopic surgery is clinically valuable in improving clinical indicators,reducing adverse reactions and regulating inflammatory cytokines for patients with acute cholecystitis. It may be the preferred choice in patients with acute cholecystitis.