腹腔镜胆囊切除术治疗急性结石性胆囊炎的临床效果

Clinical effect of laparoscopic cholecystectomy on acute calculous cholecystitis

目的探讨腹腔镜胆囊切除术治疗急性结石性胆囊炎的临床效果。方法选取2015年1月~2018年12月我院收治的40例急性结石性胆囊炎患者作为研究对象,按照随机数字表法分为对照组(20例)与研究组(20例)。研究组实施腹腔镜胆囊切除术,对照组实施传统开腹胆囊切除术。比较两组的手术相关指标(包括手术时间、术中的出血量、切口长度、住院时间),术后肠胃功能恢复情况(包括肠鸣音恢复时间、肛门排气时间、排便时间、进食时间),手术前后的视觉模拟量表(VAS)评分,术后并发症发生情况(包括切口感染、胆管损伤、出血、肠粘连)。结果两组患者的手术时间比较,差异无统计学意义(P>0.05);研究组的术中出血量少于对照组,差异有统计学意义(P<0.05);研究组的切口长度、住院时间短于对照组,差异有统计学意义(P<0.05);研究组的肠鸣音恢复时间、肛门排气时间、排便时间、进食时间短于对照组,差异有统计学意义(P<0.05);研究组患者术后VAS评分、并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论急性结石性胆囊炎采用腹腔镜胆囊切除术治疗,可以取得较理想的临床效果,可以明显缩短手术相关指标的时间,促进术后肠胃功能快速恢复,降低术后疼痛感以及术后并发症的发生率,改善疾病预后,值得推广应用。

Objective To investigate the clinical effect of laparoscopic cholecystectomy in the treatment of acute calculous cholecystitis.Methods From January 2015 to December 2018,40 patients with acute gallstone cholecystitis admitted to our hospital were selected as the subjects.They were divided into control group(n=20)and study group(n=20)by random number table method.The study group performed a laparoscopic cholecystectomy and the control group performed a conventional open cholecystectomy.The operative parameters of the two groups(including the time of operation,the amount of blood loss during the operation,the length of the incision,the time of hospitalization),the recovery of the gastrointestinal function after operation(including the recovery time of the bowel sounds,the time of the anal exhaust,the time of defecation,the time of feeding),the visual analogue scale(VAS)score before and after the operation,the occurrence of postoperative complications(including incision infection,bile duct injury,hemorrhage,intestinal adhesion)were compared.Results There was no significant difference in operation time between the two groups(P>0.05).The amount of intraoperative bleeding in the study group was less than that in the control group(P<0.05).The incision length and hospitalization time in the study group were shorter than those in the control group(P<0.05).The recovery time of bowel sounds,exhaust time,defecation time and eating time of the study group were shorter than those of the control group,with statistical significance(P<0.05).The VAS score and the total incidence of complications in the study group were lower than those in the control group(P<0.05).Conclusion Laparoscopic cholecystectomy for acute calculous cholecystitis can achieve ideal clinical results,shorten the time of operation-related indicators,promote rapid recovery of gastrointestinal function,reduce postoperative pain and complications,and improve the prognosis of the disease.It is worth popularizing and applying.