腹腔镜下胆囊切除术在胆结石治疗中的应用价值

Application value of laparoscopic cholecystectomy in the treatment of cholelithiasis

目的探讨胆结石治疗中应用腹腔镜下胆囊切除术治疗的临床价值。方法选取2015年1月~2017年12月江西省高安市中医院收治的200例胆结石患者行腹腔镜胆囊切除术治疗作为研究对象,分析患者的治疗效果。结果治疗后,显效102例(占51.00%),有效84例(占42.00%),无效14例(占7.00%),临床总有效率为93.00%。手术时间为(69.52±11.35)min,术中出血量为(43.56±9.36)ml,术后首次排气时间为(13.36±3.25)h,术后首次下床时间为(12.66±4.58)h,住院时间为(5.02±1.36)d。腹腔感染12例(占6.00%),切口感染8例(占4.00%),呼吸道感染6例(占3.00%),肾功能不全2例(占1.00%),并发症总发生率为14.00%。治疗后,胆结石患者的生活质量评分均明显高于治疗前,差异均有统计学意义(P<0.05)。结论在胆结石治疗中应用腹腔镜下胆囊切除术治疗可取得良好效果,并发症发生率相对较低,可有效改善患者的生活质量,具有显著临床价值,值得推广。

Objective To investigate the clinical value of laparoscopic cholecystectomy in the treatment of cholelithiasis. Methods A total of 200 cholelithiasis patients admitted to Gao′an Hospital of Troditional Chinese Medicine in Jiagnxi Province from January 2015 to December 2017 were selected for laparoscopic cholecystectomy, and the therapeutic effect of the patients was analyzed. Results After treatment, 102 cases（51.00%） were markedly effective, 84 cases（42.00%） were effective, 14 cases（7.00%） were ineffective, and the total clinical effective rate was 93.00%. The operation time was（69.52±11.35） min, the amount of bleeding during the operation was（43.56 ±9.36） ml, the first time of exhausting gas after the operation was（13.36±3.25） h, the first time of getting out of bed after the operation was（12.66±4.58） h, and the hospital stay was（5.02±1.36） d. There were 12 cases of abdominal infection（6.00%）, 8 cases of incision infection（4.00%）, 6 cases of respiratory infection（3.00%）, 2 cases of renal insufficiency（1.00%）, and the total incidence of complications was 14.00%. After treatment, the quality of life scores of gallstone patients were significantly higher than those before treatment, the differences were statistically significant（P〈0.05）. Conclusion The application of laparoscopic cholecystectomy in the treatment of gallstones can achieve good results, the incidence of complications is relatively low, and can effectively improve the quality of life of patients. It has significant clinical value and is worth promoting.