腹腔镜胆囊切除术与开腹胆囊切除术治疗胆结石的临床效果

Clinical effect of laparoscopic cholecystectomy and open cholecystectomy in the treatment of gallstone

目的对照分析腹腔镜胆囊切除术与开腹胆囊切除术治疗胆结石的临床疗效。方法 108例胆结石患者作为研究对象,遵循随机原则将其分为腹腔镜组和开腹组,每组54例。腹腔镜组患者采取腹腔镜胆囊切除术进行治疗,开腹组患者实施开腹胆囊切除术进行治疗,观察比较两组患者手术治疗及并发症发生情况。结果腹腔镜组患者手术时间略长于开腹组,但比较差异无统计学意义(P>0.05);腹腔镜组患者术中出血量、肠道功能恢复时间、住院时间均明显少于开腹组,且镇痛药物使用率(5.56%)明显低于开腹组(42.59%),差异均具有统计学意义(P<0.05)。腹腔镜组患者切口感染、呼吸道感染、腹腔感染、肾功能不全发生率分别为1.85%、3.70%、1.85%、0,均显著低于开腹组的14.81%、14.81%、12.96%、7.41%,差异均具有统计学意义(P<0.05)。结论腹腔镜胆囊切除术在胆结石的治疗中,虽然手术操作时间稍微延长,但是其在术中出血量、肠道功能恢复时间、术后镇痛药物使用率和住院时间等方面均显著优于开腹胆囊切除术,且腹腔镜胆囊切除术以其微创性,显著降低了患者术后各类并发症的发生率,更加利于患者术后恢复。

Objective To comparatively analyze the clinical efficacy of laparoscopic cholecystectomy and open cholecystectomy in the treatment of gallstone. Methods A total of 108 gallstone patients as study subjects were randomly divided into laparoscopic group and open group, with 54 cases in each group. The laparoscopic group was treated with laparoscopic cholecystectomy, and the open group was treated with open cholecystectomy. Observation and comparison were made on surgical treatment and occurrence of complications between two groups. Results The laparoscopic group had a little longer operation time than open group, but the difference was not statistically significant （P〉0.05）. The laparoscopic group had obviously less intraoperative bleeding volume, intestinal function recovery time and hospitalization time than the open group, and obviously lower analgesic drug utilization rate （5.56%） than open group （42.59%）. Their difference was statistically significant （P〈0.05）. The laparoscopic group had incidence of incision infection, respiratory tract infection, abdominal infection and renal insufficiency respectively as 1.85%, 3.70%, 1.85% and 0, which were obviously lower than 14.81%, 14.81%, 12.96% and 7.41% in open group, and their difference was statistically significant （P〈0.05）. Conclusion For the treatment of gallstones, although the operation time of laparoscopic cholecystectomy is slightly prolonged, but the intraoperative bleeding volume, intestinal function recovery time, postoperative analgesic utilization rate and hospitalization time are significantly better than open cholecystectomy, and laparoscopic cholecystectomy can significantly reduce incidence of all kinds of complications due to its minimally invasive. It is more conducive to postoperative recovery.