腹腔镜胆囊切除术与开腹胆囊切除术治疗老年急性胆囊炎的疗效比较

The efficacy of laparoscopic cholecystectomy and open cholecystectomy in the treatment of elderly patients with acute cholecystitis

目的探讨与比较腹腔镜胆囊切除术与开腹胆囊切除术治疗老年急性胆囊炎的临床疗效。方法收集本院2013年8月至2015年8月收治的急性胆囊炎老年患者100例前瞻性研究且随机分为两组，每组50例，腹腔镜组患者给予腹腔镜胆囊切除术治疗，开腹组则给予开腹胆囊切除术治疗，比较两组患者的手术相关指标、术后相关临床指标与并发症情况。结果腹腔镜组患者切口长度、术中出血量与手术时间显著低于开腹组[（2．19±0．57）cm vs．（8．78±1．87）cm、（58．47±20．14）ml vs．（95．49±34．47）ml、（59．34±13．75）min vs．（78．28±18．67）min]，两组比较差异有统计学意义（P〈0．01）；腹腔镜组患者肠道恢复时间、拆线时间与住院时间显著低于开腹组[（3．07±1．11）d vs．（5．87±1．85）d、（7．05±1．35）d vs．（14．35±2．72）d、（7．98±1．46）d vs．（12．76±2．25）d]，两组比较差异有统计学意义（P〈0．01）；腹腔镜组患者总体并发症发生率显著低于开腹组（6．0％vs．30．0％），两组比较差异有统计学意义（P〈0．01）。结论腹腔镜胆囊切除术治疗老年急性胆囊炎术中创伤小、术后恢复快、安全性高，总体临床效果优于开腹胆囊切除术，具有借鉴性。

Objective To evaluate and compare the clinical efficacy of laparoscopic cholecystectomy and open cholecystectomy in the treatment of elderly patients with acute cholecystitis. Methods 100 cases of acute cholecystitis in our hospital from August 2013 to August 2015 were randomly divided into two groups with 50 cases in each group. Laparoscopic group was treated with laparoscopic cholecystectomy, laparotomy group was treated with open cholecystectomy. Compared clinical indicators and postoperative complications. Results The length of incision, blood loss, and operation time in laparoscopic group were significantly lower than those in laparotomy group [（2.19±0.57）cm vs.（8.78±1.87）cm, （58.47±20.14）ml vs.（95.49±34.47）ml, （59.34±13.75）min vs.（78.28±18.67）min], with statistically significant differences （P〈0.01）. The intestinal recovery time, stitches time, and hospital stay in laparoscopic group were significantly lower than those in laparotomy group [（3.07±1.11）d vs.（5.87±1.85）d, （7.05±1.35）d vs.（14.35±2.72）d, （7.98±1.46）d vs.（12.76±2.25） d], with statistically significant differences （P〈0.01）. The incidence of complications in laparoscopic group was significantly lower than that in laparotomy group （6.0% vs.30.0%）, with statistically significant difference （P〈0.01）. Conclusion Laparoscopic cholecystectomy for acute cholecystitis in elderly patients has small trauma surgery, quick recovery, high security, whose overall clinical effect is better than that of open cholecystectomy, with reference.