腹腔镜手术与传统手术治疗胆囊结石患者123例的临床对比

Comparative study of clinical effect of the laparoscopic cholecystectomy and the laparotomy cholecystectomy in the treatment of 123 cases with gallbladder stone

目的：探讨比较腹腔镜手术与传统手术治疗胆囊结石患者的临床疗效。方法：选择123例患者随机分为治疗组62例和对照组61例。观察组采用腹腔镜胆囊切除术，对照采用开腹胆囊切除术。观察比较两组手术时间、术中出血量、术后抗生素应用时间、肛门排气时间、下床活动时间、平均住院时间、VAS 评分及术后不良反应发生率。结果：观察组手术时间、术中出血量、术后抗生素应用时间、肛门排气时间、下床活动时间、平均住院时间均少于对照组（ P ＜0．05）。观察组VAS 轻度比率为51．61％，中度比率为40．32％，重度比率为8．06％，明显低于对照组 VAS 轻度比率为37．70％，中度比率为29．51％，重度比率为32．79％，（Z ＝-6．360，P ＝0．000）。观察组患者不良反应率6．45％，明显低于对照组42．62％（χ^2＝7．728，P＝0．005）。结论：腹腔镜手术治疗胆囊结石临床疗效显著，可以显著缩短手术时间、术中出血量、术后抗生素应用时间、肛门排气时间、下床活动时间、平均住院时间，减轻患者疼痛，毒副反应轻，改善患者生活质量。

Objective ：This study aims to compare the clinical effect of the laparoscopic cholecystectomy and the laparotomy cholecystectomy in the treatment of 123 cases with gallbladder stone .Methods ：123 patients who admitted into our hospital 2016 were randomly divided into observation group （n= 62） and control group （n= 61） . The observation group was treated by laparoscopic cholecystectomy ,and the control was treated by laparotomy cholecystectomy .It observed and compared the operation time ,the blood loss ,the postoperative antibiotic application time ,the anal exhaust time ,the time of the bed ,the average length of stay ,the VAS score and the incidence of postoperative adverse events ofthe two groups .Results ：After treatment ,the operation time ,the blood loss ,the postoperative antibiotic application time ,the anal exhaust time ,the time of the bed ,the average length of stay in the observation group were less than those of in the control group （P〈 0 .05） .In the observation group ,the VAS mild ratio of 51 .61% ,moderate ratio of 40 .32% and severe ratio of 8 .06% was significantly lower than those of in the control group （Z = - 6 .360 , P= 0 .000） .The adverse reaction rate of 6 .45% in the observation group was significantly lower than that of 42 .62% in the control group （χ^2 = 7 .728 ,P= 0 .005） .Conclusion ：It has significantly clinical curative effect of laparoscopic cholecystectomy in the treatment of cholecystolithiasis .It can significantly shorten the operation time ,the blood loss ,the postoperative antibiotic application time ,the anal exhaust time ,the time of the bed ,the average length of stay ,the VAS score and the incidence of postoperative adverse events .It is worthy of popularization and application .