腹腔镜胆囊切除术与小切口胆囊切除术治疗胆结石合并胆囊炎临床比较

Clinical comparison of laparoscopic cholecystectomy with small incision cholecystectomy in treatment of gallstones merger cholecystitis

目的对比观察腹腔镜胆囊切除术(LC)与小切口胆囊切除(MC)治疗胆囊结石合并胆囊炎的临床效果。方法回顾性分析行胆囊切除术的134例胆囊结石合并胆囊炎患者的临床资料,根据术式差异将134例患者分为LC组(n=74例)和MC组(n=60例),LC组患者选择腹腔镜胆囊切除术,MC组患者选择小腹部切口胆囊切除术,统计两组患者手术时间、术中出血量、术后胃肠道功能恢复时间、引流管拔除时间、总引流量、术后住院时间、术后局部疼痛程度、住院费用等指标,均行组间数据对比。结果 MC组患者术后胃肠功能恢复时间(24.7±5.8)h、术中出血量(58.5±32.3)ml、手术时间(52.4±12.0)min、引流管拔除时间(2.1±0.5)d、总引流量(56.7±12.7)ml、术后住院时间(4.9±1.6)d、术区疼痛VAS评分(3.5±1.9)分,上述指标与LC组较为接近,差异无统计学意义(P>0.05),MC组患者住院总费用(4 580.5±394.7)元,显著低于LC组,差异存在统计学意义(P<0.05)。结论采用腹部小切口胆囊切除术治疗胆结石合并胆囊炎患者能够取得与腹腔镜术式相近的微创治疗效果,技术设备要求相对较低,治疗费用低,临床工作中可根据患者个体化差异灵活选用。

Objective To observe the effect of laparoscopic cholecystectomy （LC） and small incision gallbladder exci- sion （MC） for treatment of gallbladder stone with eholeeystitis. Methods A retrospective analysis of 2016 in our hospi- tal during the period of January - December 2016 in general surgery line eholeeysteetomy of the clinical data of 134 pa- tients with gallbladder stone with cholecystitis, according to the different operative methods 134 patients were divided in- to LC group （ n = 74） and MC group （ n = 60）, LC patients choose laparoscopic cholecystectomy, MC patients choose small abdominal incision cholecystectomy, statistics of two groups of operation time, intraoperative blood loss, postopera- tive patients with gastrointestinal function recovery time, drainage tube removal time, total flow rate and postoperative hospital stay, postoperative local pain degree, hospitalization expenses and other indicators, both line contrast between the data set. Results MC patients postoperative gastrointestinal function recovery time （24.7 ± 5.8） h, intraoperative blood loss （58. 5 ± 32. 3 ） for ml, operation time （52. 4 ± 12.0） min, drainage tube removal time （2. 1 ± 0. 5） d, total flow rate （56. 7 ± 12. 7） for ml and postoperative length of hospital stay （4. 9 ± 1.6） the area d, pain VAS score （3.5 - 1.9）, the above indicators and LC group is relatively close, there was no statistically significant difference （ P 〉 0. 05 ）, the MC group of patients in the hospital total cost （4580. 5 ± 394.7 ） yuan, significantly lower than the LC group, the difference is statistically significant （P 〈 0. 05）. Conclusion Abdominal small incision cholecystectomy in the treatment of gallstones merger cholecystitis patients can obtain similar to laparoscopic surgery minimally invasive treatment effect, technology and equipment requirements are relatively low, low treatment cost, can choose according to individual differences in patients with clinical work.