开腹手术与腹腔镜微创治疗胆囊结石合并胆囊炎的临床效果比较

Clinical effect comparison of laparotomy and laparoscopic minimally invasive surgery on gallbladder stone complicated with cholecystitis

目的观察开腹手术与腹腔镜胆囊切除术治疗胆囊结石合并胆囊炎的效果。方法将我院收治的80例胆囊结石合并胆囊炎患者根据治疗方法分为对照组(n=30)和观察组(n=50)。对照组采用开腹手术治疗,观察组采用腹腔镜微创手术治疗,比较两组临床效果。结果观察组术中出血量少于对照组,住院时间短于对照组,切口长度短于对照组,术后下床活动时间早于对照组(P<0.05)。两组治疗后1、3 d的IL-6、CRP水平高于治疗前,治疗后7 d的IL-6、CRP水平低于治疗后1、3 d(P<0.05),对照组治疗后7 d的IL-6、CRP水平仍高于治疗前(P<0.05)。观察组治疗后1、3、7 d的IL-6、CRP水平均低于同时间对照组(P<0.05)。观察组切口感染、积液发生率显著低于对照组(P<0.05)。结论采用腹腔镜微创手术治疗胆囊结石合并胆囊炎,临床治疗效果优于开腹手术治疗。

Objective To observe the effects of laparotomy and laparoscopic minimally invasive surgery on gallbladder stone complicated with cholecystitis. Methods Eighty cases of gallbladder stone complicated with cholecystitis in our hospital were divided into control group （n=30） and observation group （n=50） according to treatment methods. The control group was treated with laparotomy, the observation group used laparoscopic minimally invasive surgery. The clinical effects between the two groups were compared. Results In the observation group, the intraoperative blood loss was less than that in the control group, the hospital stay was shorter than that in the control group, the incision length was shorter than that in the control group, the time of getting out of bed was earlier than that in the control group （P〈0.05）. At 1, 3 days after treatment, the levels of IL-6 and CRP in the two groups were significantly higher than those before treatment （P〈0.05）. The levels of IL-6 and CRP at 7 days after treatment were significantly lower than those at 1 day and 3 days after treatment （P〈0.05）; the levels of IL-6, CRP at 7 d after treatment in the control groups were still higher than those before treatment （P〈0.05）; the levels of IL-6 and CRP in the observation group were lower than those in the control group at 1, 3 and 7 days after treatment （P〈0.05）; the incidence rates of incision infection and effusion in the observation group were lower than those in the control group （P〈0.05）. Conclusion The clinical effect of laparoscopic minimally invasive surgery on gallbladder stone complicated with cholecystitis is superior to laparotomy surgery.