腹腔镜胆囊切除术治疗胆结石并胆囊息肉的效果及对并发症发生率的影响

The Effect of Laparoscopic Cholecystectomy in the Treatment of Gallstones and Polyps of the Gallbladder and Its Influence on the Incidence of Complications

目的:探索腹腔镜胆囊切除术在胆结石合并胆囊息肉患者中的应用效果及对并发症发生率的影响。方法:在本院肝胆外科2018年2月-2019年10月收诊的胆结石合并胆囊息肉患者中选出140例为对象,根据手术方式分组,开腹组应用开放性胆囊切除术治疗,腹腔镜组应用腹腔镜下胆囊切除术治疗,对比两组的手术时间、术中出血量、术后并发症发生率、术后住院时间等。结果:两组手术时间差异无统计学意义(P>0.05);腹腔镜组的术中出血量、术后肛门排气时间、术后下床活动时间、术后住院时间均优于开腹组(P<0.05);腹腔镜组的总有效率为98.57%,高于开腹组的总有效率90.00%,差异有统计学意义(P<0.05);腹腔镜组的术后并发症发生率为5.71%,低于开腹组的17.14%,差异有统计学意义(P<0.05);腹腔镜组术后镇痛药物使用率为10.00%,低于开腹组的22.86%,差异有统计学意义(P<0.05)。结论:腹腔镜胆囊切除术在胆结石并胆囊息肉患者中应用效果确切,手术创伤小,患者术后并发症发生率低,术后康复快,值得推广。

Objective:To explore the effect of laparoscopic cholecystectomy in patients with gallstones and polyps of the gallbladder and its influence on the incidence of complications.Method:A total of 140 patients with gallstones and gallbladder polyps admitted to the Department of Hepatobiliary Surgery in our hospital from February 2018 to October 2019 were selected as subjects.They were grouped according to the surgical method.The open group was treated with open cholecystectomy.The endoscopic group was treated with laparoscopic cholecystectomy,and the operation time,intraoperative blood loss,postoperative complications,and postoperative hospital stay were compared between the two groups.Result:There was no statistically significant difference in operation time between the two groups(P>0.05);the intraoperative blood loss,postoperative anus exhaust time,postoperative time to get out of bed,and postoperative hospital stay in the laparoscopic group were better than those in the laparotomy group(P<0.05);the total effective rate of the laparoscopic group was 98.57%,which was higher than the total effective rate of the open group of 90.00%,the difference was statistically significant(P<0.05);the postoperative complication rate of the laparoscopic group was 5.71%,which was lower than 17.14%in the open group,and the difference was statistically significant(P<0.05);the postoperative analgesic use rate in the laparoscopic group was 10.00%,which was lower than 22.86%in the open group,and the difference was statistically significant(P<0.05).Conclusion:Laparoscopic cholecystectomy is effective in the treatment of patients with gallstones and polyps of the gallbladder.The surgical trauma is small,the incidence of postoperative complications is low,and the postoperative recovery is fast.It is worthy of promotion.