腹腔镜胆囊切除术治疗急性发作期胆囊炎的临床体会

Clinical Experience of Laparoscopic Cholecystectomy in Treatment of A-cute Episode Stage Cholecystitis

目的探究对于治疗急性发作期胆囊炎时使用腹腔镜胆囊切除术的临床体会。方法选取该院在2015年1月—2018年2月期间接受治疗的急性发作期胆囊炎患者137例作为研究对象,根据患者的治疗手术的不同分为对照组69例实行一般手术,观察组68例进行腹腔镜胆囊切除术,对比两组患者的术中出血量,手术时间,住院时间和并发症发生率。结果观察组患者的平均手术时间为(36.45±10.22)min,平均术中出血量为(33.42±15.18)mL,平均住院时间为(4.16±1.55)d,均显著低于对照组患者(t=12.538,11.447,6.293,P<0.05);住院期间,对照组患者有3例发生切口感染,5例发生伤口渗血,1例患者发热,1例患者皮肤黄染,不良反应发生率为14.49%(10/69);观察组患者1例切口感染,1例皮肤黄染,不良反应发生率为2.94%(2/68),显著低于对照组患者(χ~2=6.779,P<0.05)。结论通过选用腹腔镜胆囊切除手术来对急性发作期胆囊炎患者进行治疗不仅治疗时间短,恢复时间短,而且安全性高,值得临床参考。

Objective To study the clinical experience of laparoscopic cholecystectomy in treatment of acute episode stage cholecystitis. Methods 137 cases of patients with acute episode stage cholecystitis admitted and treated in our hospital from January 2015 to February 2018 were selected and divided into two groups according to different operation methods, the control group with 69 cases used the general surgery, while the observation group with 68 cases were treated with laparoscopic cholecystectomy, and the intraoperative bleeding amount, operation time, length of stay and incidence rate of complications were compared between the two groups. Results The average operation time, average intraopeative bleeding amount and average length of stay in the observation group were respectively（36.45±10.22） min,（33.42±15.18） mL,（4.16±1.55） d, which were obviously lower than those in the control group（t=12.538, 11.447, 6.293,P〈0.05）; 3 cases had the incision infection, 5 cases had the wound staxis, 1 case was fever, 1 case had the xanthochromia, and the incidence rate of adverse reactions was 14.49%（10/69） in the control group during the length of stay, and 1 case had the incision infection, 1 case had the xanthochromia in the observation group, and the incidence rate of adverse reactions was 2.94%（2/68）, which was obviously lower than that in the control group（χ^2=6.779, P〈0.05）.Conclusion The laparoscopic cholecystectomy in treatment of acute episode stage cholecystitis has a short treatment effect and short recovery time, with high safety, and it is worth clinical reference.