腹腔镜胆囊切除术治疗急性胆囊炎合并胆结石的疗效研究

Laparoscopic Cholecystectomy for the Treatment of Acute Cholecystitis with Gallstones

目的:探讨腹腔镜胆囊切除术治疗急性胆囊炎合并胆结石的疗效。方法:将2018年3月~2019年3月本院收治的140例急性胆囊炎合并胆结石患者按治疗方法分为两组各70例,分别采用腹腔镜胆囊切除术与传统开腹术治疗,分别设为腹腔镜组和开腹组。比较两组术后恢复情况、血清淀粉酶与C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平及术后并发症。结果:腹腔镜组肛门排气时间、首次下床活动时间、疼痛持续时间、引流管置管时间、住院时间均明显少于开腹组(P<0.05)。两组患者术前与术后血清淀粉酶指标对比有明显差异(P>0.05),但腹腔镜组术后的CRP、TNF-α水平明显低于开腹组(P<0.05)。腹腔镜组术后总的并发症发生率为2.9%,明显低于开腹组14.3%(P<0.05)。结论:急性胆囊炎合并胆结石采用腹腔镜胆囊切除术治疗,创伤轻,痛苦小,应激反应轻,恢复快,较传统开腹术有明显的优势。

Objective:To explore the effect of laparoscopic cholecystectomy for acute cholecystitis with gallstones.Methods:140 patients with acute cholecystitis and gallstones were divided into two groups of 70 patients according to the treatment method.They were treated with laparoscopic cholecystectomy and traditional laparotomy.They were divided into laparoscopic group and laparotomy group.Postoperative recovery,serum amylase and C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)levels and postoperative complications were compared between the two groups.Results:The time of anal exhaustion,time to get out of bed for the first time,duration of pain,drainage tube placement time,and hospitalization time in the laparoscopic group were significantly less than those in the laparotomy group(P<0.05).There was a significant difference in serum amylase indexes between the two groups before and after operation(P>0.05),but the CRP and TNF-αlevels in the laparoscopic group were significantly lower than those in the open group(P<0.05).The total postoperative complication rate in the laparoscopic group was 2.9%,which was significantly lower than that in the laparotomy group(14.3%)(P<0.05).Conclusion:Acute cholecystitis combined with gallstones is treated by laparoscopic cholecystectomy,with less trauma,less pain,lighter stress response and faster recovery,which has obvious advantages over traditional laparotomy.