腹腔镜胆囊切除术治疗急性结石性胆囊炎的效果观察

Effect of Laparoscopic Cholecystectomy in the Treatment of Acute Calculous Cholecystitis

目的探讨对急性结石性胆囊炎患者选择腹腔镜胆囊切除术治疗后获得的临床效果。方法选择该院2016年12月—2018年4月收治的44例急性结石性胆囊炎患者作为实验对象;抽签法分组后明确各组手术方法;对照组(22例):选择开腹胆囊切除术展开治疗;观察组(22例):选择腹腔镜胆囊切除术展开治疗;对比手术效果。结果观察组术中失血量为(173.65±22.66)mL,手术时间为(59.62±10.55)min,住院时间为(6.36±2.02)d,术后排气时间为(21.75±7.99)h;对照组术中失血量为(257.95±38.45)mL,手术时间为(72.39±12.63)min,住院时间为(9.69±2.85)d,术后排气时间为(38.25±8.55)h;同对照组急性结石性胆囊炎患者术中术后指标对比,观察组术中失血量、手术时间、住院时间以及术后排气时间均获明显缩短(t=8.859 4、3.639 6、4.471 1、6.613 4,P=0.000 0、0.000 7、0.000 1、0.000 0);治疗前,两组患者在应激指标方面差异无统计学意义(P>0.05),治疗后,两组应激指标均显著提升(t=42.086 6,75.985 7;P=0.000 0,0.000 0);同对照组急性结石性胆囊炎患者应激指标对比,观察组皮质醇水平以及CRP水平表现出更小提升幅度(P<0.05);同对照组急性结石性胆囊炎患者术后并发症(54.55%)对比,观察组总发生率(9.09%)表现出明显降低(χ^2=10.476 2,P=0.001 2);同对照组急性结石性胆囊炎患者术后切口疼痛评分对比,观察组表现出明显降低(t=13.694 0,P=0.000 0)。结论腹腔镜胆囊切除术用于治疗急性结石性胆囊炎,创伤小、恢复快,疗效显著,值得应用推广。

Objective To investigate the clinical effects of laparoscopic cholecystectomy in patients with acute calcu-lous cholecystitis. Methods Forty-four patients with acute calculous cholecystitis admitted to this hospital from Decem-ber 2016 to April 2018 were selected as experimental subjects. The grouping method was used to determine the surgi-cal methods of each group. The control group (22 cases): the choice of open cholecystectomy treatment;the observation group (22 cases): laparoscopic cholecystectomy was selected for treatment;the surgical results were compared. Results The blood loss during the operation was (173.65±22.66) mL, the operation time was (59.62±10.55) min, the hospital stay was (6.36±2.02) d, and the postoperative exhaust time was (21.75±7.99) h. The intraoperative blood loss was (257.95±38.45) mL, the operation time was (72.39±12.63) min, the hospitalization time was (9.69±2.85) d, and the post-operative exhaust time was (38.25±8.55) h. Intraoperative and postoperative indexes of patients with calculous cholecys-titis, the blood loss, operation time, hospital stay and postoperative exhaust time were significantly shortened in the ob-servation group (t=8.859 4,3.639 6,4.471 1,6.613 4;P=0.000 0,0.000 7,0.000 1,0.000 0);before treatment, there was no statistically significant difference in stress index between the two groups. After treatment, the stress indexes of both groups were significantly increased (t=42.086 6,75.985 7;P=0.000 0,0.000 0);Compared with the stress index of pa-tients with calculous cholecystitis, the cortisol level and CRP level of the observation group showed a smaller increase (P <0.05);the postoperative complications of patients with acute calculous cholecystitis in the same control group (54.55%) comparison, total incidence of observa-tion group (9.09%) showed a significant decrease (χ^2= 10.476 2,P =0.001 2);compared with the incision pain score of patients with acute calculous cholecystitis in the control group, the observation group showed a significant decrease (t=13.694 0,P=0.000 0). Conclusion Laparoscopic cholecystectomy is an effective treatment for acute calcu-lous cholecystitis with less trauma, quick recovery and significant curative effect.