延迟腹腔镜胆囊切除术应用于老年急性结石性胆囊炎的临床疗效和安全性研究

Clinical Efficacy and Safety of Delayed Laparoscopic Cholecystectomy in Elderly Patients with Acute Calculous Cholecystitis

目的探讨延迟腹腔镜胆囊切除术应用于老年急性结石性胆囊炎的临床疗效和安全性。方法选取该院2018年4月—2021年3月收治的70例老年急性结石性胆囊炎患者作为研究对象,随机将其分为观察组(n=35)和对照组(n=35)。观察组采用延迟腹腔镜胆囊切除术,对照组采用早期腹腔镜胆囊切除术,对比两组患者的围术期指标、实验室检查指标、并发症发生情况、30 d病死率。结果观察组患者的手术时间(78.26±11.23)min、术后引流时间(5.78±1.68)d以及术中出血量(45.60±16.95)mL明显低于对照组,差异有统计学意义(P<0.05);观察组患者总并发症发生率(20.00%)低于对照组(42.86%)(χ^(2)=4.242,P<0.05),两组患者30 d病死率对比差异无统计学意义(P>0.05)。结论将延迟腹腔镜胆囊切除术应用于老年急性结石性胆囊炎患者中,可以缩短患者的手术时间,减少患者术中出血量,缩短术后引流时间,减少患者并发症发生率,并且缩短患者术后住院天数,减少患者30 d内病死率。

Objective To investigate the clinical efficacy and safety of delayed laparoscopic cholecystectomy in elderly patients with acute calculous cholecystitis.Methods A total of 70 elderly patients with acute calculous cholecystitis who were treated in the hospital from April 2018 to March 2021 were selected as the research objects,and they were randomly divided into the observation group(n=35)and the control group(n=35).The observation group was treated with delayed laparoscopic cholecystectomy,and the control group was treated with early laparoscopic cholecystectomy.The perioperative indicators,laboratory test indicators,complications and 30 d mortality were compared between the two groups.Results The operation time(78.26±11.23)min,postoperative drainage time(5.78±1.68)d and intraoperative blood loss(45.60±16.95)mL of the observation group were significantly lower than those of the control group,the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was 20.00%lower than that in the control group(42.86%),the difference was statistically significant(χ^(2)=4.242,P<0.05).There was no statistically significant difference in the 30 d mortality between the two groups(P>0.05).Conclusion The application of delayed laparoscopic cholecystectomy in elderly patients with acute calculous cholecystitis can shorten the operation time,reduce the intraoperative blood loss,shorten the postoperative drainage time,and reduce the incidence of complications,and shorten the postoperative hospital stay,reduce the mortality of patients within 30 d.