针刺减压与吸引器减压在急性胆囊炎腹腔镜胆囊切除术中的应用

Application of acupuncture decompression and aspirator puncture decompression in laparoscopic cholecystectomy for patients with acute cholecystitis

目的:探讨急性胆囊炎行腹腔镜胆囊切除术中应用针刺减压与吸引器减压的安全性及优劣。方法:回顾分析2021年1月1日至2021年6月1日为101例急性胆囊炎患者行腹腔镜胆囊切除术的临床资料,其中50例采用针刺减压(针刺组),51例采用吸引器穿刺减压(吸引器组)。结果:101例患者均顺利完成腹腔镜胆囊切除术,无并发症发生。术后第1天、第3天,两组白细胞、中性粒细胞百分比、C反应蛋白差异无统计学意义,术中出血量、术后排气时间、术后住院时间、细菌培养阳性、总费用差异亦无统计学意义。吸引器组手术时间短于针刺组[(95.4±10.1)min vs.(114.0±3.0)min,P<0.05],差异有统计学意义。术后病理示急性胆囊炎或慢性胆囊炎急性发作(合并或不合并胆囊结石)。结论:在多种方法结合、仔细操作的前提下,急性胆囊炎行腹腔镜胆囊切除术是安全、有效的,吸引器减压较针刺减压效果更好。

Objective:To explore the safety,advantages and disadvantages of acupuncture decompression and aspirator decompression in laparoscopic cholecystectomy for acute cholecystitis.Methods:The clinical data of 101 patients with acute cholecystitis who underwent laparoscopic cholecystectomy from Jan.1st 2021 to Jun.1st 2021 were retrospectively analyzed.50 patients received acupuncture decompression and 51 underwent aspirator puncture decompression,respectively.Results:All patients successfully completed laparoscopic cholecystectomy without complications.There was no significant difference in WBC,neutrophilic granulocyte percentage,C-r eactive protein on the first and third day after operation,and intraoperative bleeding,postoperative exhaust time,postoperative hospital stay,bacterial culture positive,and total cost between the two groups.The operation time of the aspirator group was significantly shorter than that of the acupuncture group[(95.4±10.1)min vs.(114.0±3.0)min,P<0.05],the difference was statistically significant.Postoperative pathology suggested acute cholecystitis or acute attack of chronic cholecystitis(with or without gallbladder stones).Conclusions:Under the premise of using multiple methods and careful operation,laparoscopic cholecystectomy for acute cholecystitis is safe and effective,and the effect of aspirator puncture decompression is better than that of acupuncture decompression.