腹腔镜微创手术与开腹手术在胆囊结石并胆囊炎治疗中的对比研究

Comparative Study of Laparoscopic Minimally Invasive Surgery and Open Surgery in the Treatment of Gallstones and Cholecystitis

目的探讨腹腔镜微创手术与开腹手术在胆囊结石并胆囊炎治疗中的对比。方法选取该院2016年1月—2018年1月之间的86例胆囊结石并胆囊炎患者,随机分为两组,观察组43例患者采用腹腔镜微创疗法治疗,对照组43例患者采用传统开腹手术治疗,对比两组患者手术相关指标和术后恢复情况以及不良反应发生情况。结果观察组患者术中出血量(32.83±7.19)mL明显低于对照组(77.75±12.60)mL,切口长度(3.23±0.24)cm和手术时间(38.45±4.02)min明显短于对照组(12.73±1.32)cm、(60.02±4.53)min,差异有统计学意义(t=10.304 5、16.432 4、12.070 3,P<0.05)。观察组患者住院时间、下床活动时间、肠鸣音恢复时间分别为(5.22±1.70)d、(25.19±8.13)h、(24.44±3.43)h,明显短于对照组(12.04±4.40)d、(49.92±9.43)h、(46.32±8.11)h,止痛剂使用比例18.60%(8/43)明显少于对照组44.19%(19/43),差异有统计学意义(t=9.481 0、13.024 5、16.294 0,χ~2=15.20.1 8,P<0.05)。观察组患者不良反应发生率13.95%,对照组为34.88%,观察组显著低于对照组(χ~2=11.869 1,P<0.05)。结论腹腔镜微创手术与开腹手术在胆囊结石并胆囊炎治疗中的不同,腹腔镜优于开腹手术。

Objective To investigate the comparison between laparoscopic minimally invasive surgery and open surgery in the treatment of gallstones and cholecystitis.Methods 86 patients with cholecystolithiasis and cholecystitis between January 2016 and January 2018 were randomly divided into two groups.43 patients in the observation group were treated with laparoscopic minimally invasive therapy and 43 patients in the control group with traditional open surgery,to compare the surgical related indexes and postoperative recovery and adverse reactions in the two groups.Results In the observation group,the intraoperative blood loss(32.83±7.19)mL was significantly lower than that of the control group(77.75±12.60)mL,the incision length was(3.23±0.24)cm,and the operation time was(38.45±4.02)min,which was significantly shorter than the control group(12.73±1.32)cm,(60.02±4.53)min,statistically significant(t=10.304 5,16.432 4,12.070 3,P<0.05).The hospitalization time,the time of getting out of bed,and the recovery time of bowel sounds in the observation group were(5.22±1.70)d,(25.19±8.13)h,(24.44±3.43)h,respectively,which were significantly shorter than the control group(12.04±4.40)d,(49.92±9.43)h,(46.32±8.11)h,the use rate of analgesic 18.60%(8/43)was significantly lower than that of the control group 44.19%(19/43),the difference was statistically significant(t=9.481 0,13.024 5,16.294 0,χ^2=15.201 8,P<0.05).The incidence of adverse reactions was 13.95%in the observation group and 34.88%in the control group.The observation group was significantly lower than the control group(χ^2=11.869 1,P<0.05).Conclusion Laparoscopic minimally invasive surgery and open surgery are different in the treatment of gallstones and cholecystitis.Laparoscopy is superior to open surgery.