腹腔镜胆囊切除术与开腹手术治疗老年急性胆囊炎效果及安全性比较

Comparison of Effect and Safety of Laparoscopic Cholecystectomy and Laparotomy in the Treatment of Elderly Patients with Acute Cholecystitis

目的比较腹腔镜胆囊切除术与开腹手术治疗老年急性胆囊炎的手术效果及安全性。方法选取2015年10月—2017年10月解放军148医院普外科收治的老年急性胆囊炎患者106例为研究对象,将接受腹腔镜胆囊切除术的53例患者设为观察组,将接受开腹手术的53例患者设为对照组,比较两组患者手术相关指标、并发症及生活质量。结果观察组术中出血量、术后住院时间分别为(64.73±16.59)mL、(6.83±2.65)d,均明显少于对照组(t=9.262、6.763,P<0.05);并发症发生率(3.77%)明显低于对照组(18.87%)(χ~2=6.014,P<0.05);总体健康、精神状况、社会活动、躯体疼痛评分分别为(85.12±1.15)分、(86.37±1.26)分、(90.11±1.24)分、(87.24±0.45)分,均明显高于对照组(t=60.209、82.272、45.190、54.494,P<0.05)。结论对老年急性胆囊炎患者实施腹腔镜胆囊切除术,创伤小、并发症少、术后恢复快,有助于提高生活质量。

Objective To compare the effect and safety of laparoscopic cholecystectomy and laparotomy in the treatment of elderly patients with acute cholecystitis. Methods A total of 106 cases of elderly patients with acute cholecystitis admitted to the general surgery department of the 148 Hospital of PLA from October 2015 to October 2017 were selected as the research objects, and divided into two groups with 53 cases in each, the observation group of patients underwent laparoscopic cholecystectomy, while the control group underwent laparotomy and the operation related indexes, complications and quality of life between the two groups were compared. Results The intraoperative blood loss and postoperative length of stay in observation group were respectively（64.73±16.59）mL and（6.83±2.65）d, significantly less than those in control group（t=9.262, 6.763, P〈 0.05）; the incidence rate of complications was 3.77%, significantly lower than 18.87% in the control group（χ2=6.014,P〈 0.05）; the scores of general health, mental condition, social activities and body pain were respectively（85.12±1.15） points,（86.37±1.26）points,（90.11 ±1.24）points and（87.24 ±0.45） points, significantly higher than those in control group（t=60.209, 82.272, 45.190, 54.494, P〈 0.05）. Conclusion Laparoscopic cholecystectomy in treating elderly patients with acute cholecystitis has the advantages of less trauma, few complications and fast recovery after operation, which is of help to improving the quality of life.