早期及延迟腹腔镜胆囊切除对急性胆囊炎患者的疗效分析

Clinical effect of laparoscopic resection compared with the early and delayed acute cholecystitis laparoscopic resection

目的 对早期行腹腔镜切除术和推迟行腹腔镜切除术治疗急性胆囊炎的临床疗效进行对照研究。方法 将2014年1月至2015年12月期间收治的100名急性胆囊炎伴胆囊结石患者随机分为两组：一组为50例急性发作的胆囊炎患者在入院3 d内行腹腔镜胆囊切除,作为早期手术组;另一组为50例急性发作的胆囊炎患者药物保守治疗3个月后行手术切除,作为推迟手术组,比较两组患者的各项指标。患者的年龄、性别、体温、白细胞计数、ALT等一般资料,用（x±s）表示,t检验进行比较;术后并发症发生率、中转开腹率,使用χ-2检验进行比较;采取SPSS19.0统计学软件进行分析,以P〈0.05为差异有统计学意义。结果 两组在中转开腹率、术后并发症及术后24 h疼痛评分之间的差异无统计学意义（P〉0.05）;但在平均住院时间、恢复工作所需方面,早期手术组分别为（6.9±2.1）d、（12.4±3.7）d明显短于推迟手术组（14.5±5.3）d、（25.8±2.9）d;差异均有统计学意义（t=6.109、13.062,P〈0.05）。结论 在临床经验丰富的医师进行手术的前提下,急性胆囊炎患者早期行腹腔镜胆囊切除相较推迟腹腔镜切除患者而言,在医疗及经济效益等层面上更具优势。

Objective To compare the early acute cholecystitis and acute cholecystitis laparoscopic gall bladder resection delay line of the safety and feasibility of laparoscopic surgery clinical effect. Methods 50 cases of acute and severe symptoms of cholecystitis patients were randomly divided into a group, and in the hospital 3 days adept laparoscopic gallbladder excision, which was regarded as early surgery group. In another group, there were 50 patients with acute chalecystitis, medicine conservative treatment for 3 months after surgery,regarding as delayed surgery group. Patient＇ s age, sex, body temperature and white blood cell count, ALT, such data are showed in the form of （x ± s ）, and compared with method of t test. The postoperative complications incidence rate, transfer laparotomy, using chi-square test to compare; Taking SPSSI9. 0 statistical analysis software, if P 〈 0. 05, the difference was statistically significant. Results The pain score in 24 hours, transit open rate and postoperative complications and postoperative of two groups were not significantly statistical different （ P 〉 0.05 ）, but in terms of the average length of hospital stay, recovery for the early surgery group respectively （6.9 ± 2. 1 ） days, （ 12.4 ± 3.7） days, which was obviously shorter than the delayed surgery group （14.5 ± 5.3 ） days, （25.8 ± 2.9）days, there was statistically significant difference （ t = 6. 109, 13.062, P 〈 0.05）. Conclusions In clinical surgery experienced doctors under the premise of early than laparoscopic gall bladder resection in patients with acute cholecystitis laparoscopic resection in patients with delayed, the more advantage in social economic and health benefits.