腹腔镜胆囊手术和开腹胆囊手术对术后肠黏连的影响比较

Comparison of the Effects of Laparoscopic Cholecystectomy and Open Laparotomy Cholecystectomy on Postoperative Intestinal Adhesion

目的:比较腹腔镜胆囊手术和开腹胆囊手术对于术后肠黏连的影响,对比两种手术的有效性和安全性。方法:回顾选取在我院接受胆囊手术治疗的196例病患,根据术式分成开腹组和腹腔组,每组均为98例患者,对比分析组间手术指标以及术后出现肠黏连的情况,同时观察手术前后患者消化道生存质量变化。结果:腹腔镜组手术耗时(123.57±4.65 min)长于开腹组,术中出血(27.52±5.69 mL)、胃肠功能恢复用时(18.03±3.51 h)、术后住院时间(4.51±1.03)、肠黏连发生率(10.20%)少于开腹组,(P<0.05);两组术前GLQI评分相仿(P>0.05),术后GLQI评分显著高于组内术前(P<0.05),且腹腔镜组术后GLQI评分显著高于开腹组(P<0.05)。结论:与开腹手术相比,腹腔镜胆囊手术不仅手术创伤小、术后恢复时间短,而且术后肠粘连发生率低,值得推广。

Objective： To compare the clinical effects of laparoscopic cholecystectomy and open laparotomy cholecystectomy on postoperative intestinal adhesion, and to compare the effectiveness and safety of the two procedures. Methods： 196 patients with chole- cystectomy in our hospital were retrospectively chosen. According to the operative procedure, they were divided into two groups： open laparotomy group and abdominal cavity group, and 98 cases in each group. The operative indexes and postoperative intestinal adhesion of the two groups were compared, and the changes of quality of life of patients with gastrointestinal tract before and after surgery were observed. Results： The laparoscopic operation time （123.57± 4.65 min） was longer than that in the open laparotomy group, bleeding dur- ing operation （27.52±5.69 mL）, recovery of gastrointestinal function time（18.03 ± 3.51 h）, postoperative hospital stay （4.51 ± 1.03） and intestinal adhesion rate （10.20%） were less than the open laparotomy group, （P〈0.05）. The GLQI scores of the two groups before surgery were similar （P〉0.05）, and the postoperative GLQI score was significantly higher than that of the preoperative group （P〈0.05）, and the GLQI score of laparoscopic group was significantly higher than that of open laparotomy group （P〈0.05）. Conclusion： Compared with open laparotomy surgery, laparoscopic cholecystectomy not only has the advantages of small operative trauma, short postoperative recov- ery time, but also low incidence of postoperative intestinal adhesion, and it is worthy of promotion.