腹腔镜胆囊切除术与开腹胆囊切除术治疗老年急性胆囊炎的效果对比

Comparison of Laparoscopic Cholecystectomy and Open Cholecystectomy in the Treatment of Acute Cholecystitis in the Elderly

目的探讨腹腔镜胆囊切除术与传统开腹胆囊切除术治疗老年急性胆囊炎患者的效果对比。方法回顾性分析2018年10月至2019年3月淮安医院收治的76例老年急性胆囊炎患者,根据不同治疗方法分为两组,每组38例。对照组患者采取常规开腹胆囊切除术治疗,观察组给予腹腔镜下胆囊切除术治疗。对比两组患者的手术期间及术后恢复情况。结果两组患者的手术用时差异无统计学意义(P>0.05);观察组患者的出血量、住院时间、肠鸣音恢复时间、首次排气时间、排便时间、VAS评分等均短于对照组(P<0.05)。观察组的术后并发症率为5.26%,显著低于对照组26.32%(P<0.05)。术后观察组患者的CD3^+、CD4^+/CD8^+、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)各指标与术前相比,差异无统计学意义(P>0.05),对照组患者术后的CD3^+、CD4^+/CD8^+、IgA、IgM均低于术前(P<0.05),且术后观察组的CD3^+、CD4^+/CD8^+、IgA、IgM均高于对照组(P<0.05)。结论在老年急性胆囊炎患者治疗中采用腹腔镜胆囊切除术更有利于降低患者的手术创伤和术后并发症率,并加快患者术后机体康复进程,且能够减少对于患者机体免疫功能产生的不良影响。

Objective To explore the effect of laparoscopic cholecystectomy or traditional open cholecystectomy in the treatment of elderly patients with acute cholecystitis.Methods From October 2018 to March 2019,76 elderly patients with acute cholecystitis from Huai'an Hospital were included and divided into two groups(38 cases in each group)according to the treatment method.The patients in the control group were treated with routine open cholecystectomy,while the patients in the observation group were treated with laparoscopic cholecystectomy at the same time.Results There was no significant differenceinoperationtime between the two groups(P>0.05).The blood loss,hospitalization time,recovery time of intestinal sound,first exhaust time,defecation time and VAS score of the observation group were all less than those of the control group(P<0.05).The postoperative complication rate of the observation group was 5.26%,whilethe control group was 26.32%(P<0.05).Comparedwith pre-opertaion,there was no significant difference in CD3^+,CD4^+/CD8^+,IgA and IgM in the experimental group(P>0.05),while CD3^+,CD4^+/CD8^+,IgA and IgM in the control group were all lower than those pre-operation(P<0.05),and CD3^+,CD4^+/CD8^+,IgA and IgM in the observation group were all higher than those in the control groupafteroperation(P<0.05).Conclusion The value of laparoscopic cholecystectomy in the treatment of elderly patients with acute cholecystitis was significantly higher than that of traditional open cholecystectomy.The former was more conducive to reduce the rate of surgical trauma and postoperative complications,accelerate the process of postoperative recovery,and reduce the adverse effects on the immune function of patients.