腹腔镜胆囊切除术治疗急性结石性胆囊炎的效果分析

Analysis of treatment effect of laparoscopic cholecystectomy in the treatment of acute calculous cholecystitis

目的探讨腹腔镜胆囊切除术治疗急性结石性胆囊炎的临床效果。方法选取我院204例急性结石性胆囊炎患者,按照手术时间的不同分为A组、B组、C组。A组患者从发病至进行手术的时间<48h,共74例;B组患者从发病至进行手术的时间在48~72h,为68例;C组患者从发病至进行手术的时间>72h,为62例。三组患者均给予腹腔镜胆囊切除术,比较三组患者的中转开腹情况、手术情况及并发症发生情况。结果 C组患者的中转开腹率明显高于A、B组(P<0.05);A、B组患者的手术时间、术中出血量、术后疼痛时间、肛门排气时间、住院时间均明显优于C组(P<0.05);C组患者的并发症总发生率明显高于A、B组(P<0.05)。结论腹腔镜胆囊切除术治疗急性结石性胆囊炎患者的效果显著,选择治疗的手术时间越短,患者的疗效和预后愈好。

Objective To investigate the effect of laparoscopic cholecystectomy in the treatment of acute calculous cholecystitis. Methods A total of 204 patients with acute calculous cholecystitis treated in our hospital were selected and divided into group A, group B and group C according to the different operation time. In the group A, the time of 74 patients from onset to performing surgery were less than 48 h; in the group B, the time of 68 patients from onset to performing surgery were less 48-72 h; in the group C, the time of 62 patients from onset to performing surgery were more than 72 h. The three groups were given laparoscopic cholecystectomy, and the condition of transferring to the laparotomy, surgery and complications were compared in the three groups. Results The rate of transferring to the laparotomy in the group C was significantly higher than that in the group A and B （P〈0.05）; the time of operation, intraoperative blood loss, postoperative pain time, anal exhaust time and hospital stay in the group A and B were significantly better than those in the group C （P〈 0.05）; the overall incidence of complications in the group C was significantly higher than that in the group A and B （P〈 0.05）. Conclusion Laparoscopic cholecystectomy has significant effect in the treatment of patients with acute calculous cholecystitis, the shorter the time of having surgery, the better the patient＇s efficacy and prognosis.