微创腹腔镜和常规开腹手术对老年急性结石性胆囊炎患者的临床疗效研究

Clinical Effect of Minimally Invasive Laparoscopy and Conventional Open Surgery on Elderly Patients with Acute Calculous Cholecystitis

目的研究老年急性结石性胆囊炎采用微创腹腔镜和常规开腹手术治疗的临床疗效。方法选取2020年9月至2021年9月义马煤业集团股份有限公司总医院收治的120例老年急性结石性胆囊炎患者,根据不同的手术方案分为观察组60例和对照组60例,其中对照组给予常规开腹手术治疗,观察组提供微创腹腔镜手术治疗。观察比较两组患者手术时间、排气时间、术中出血量、VAS评分(术后3 h、术后6 h、术后12 h、术后24 h)、切口长度、术后各项指标的恢复情况,同时比较两组术后并发症发生率。结果观察组手术时间、术中出血量及切口长度等各项指标均优于对照组,差异有统计学意义(P<0.05)。观察组术后3 h、术后6 h、术后12 h、术后24 h的VAS分数低于对照组,差异有统计学意义(P<0.05)。术后观察组禁食时间和抗菌治疗时间与对照组比较,差异无统计学效果(P>0.05),但住院时间、肠功能恢复时间和术后排气时间等均短于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率(11.66%)明低于对照组(28.33%),差异有统计学意义(χ^(2)=18.532,P=0.011)。结论微创腹腔镜手术用在治疗急性胆囊炎的安全性较好,使临床治疗效率得到改善,并且降低了并发症的发病概率。

Objective To investigate the clinical efficacy of minimally invasive laparoscopic and conventional open surgery in the treatment of acute calculous cholecystitis in senile patients.Methods A total of 120 elderly patients with acute calculous cholecystitis admitted to the General Hospital of Yima Coal Industry Group Co,Ltd.from September 2020 to September 2021 were selected and divided into an observation group(60 cases)and a control group(60 cases)according to different surgical plans.The control group received conventional open surgery,and the observation group received minimally invasive laparoscopic surgery.The operation time,exhaust time,intraoperative blood loss,VAS score(3 h,6 h,12 h,24 h after operation),incision length,and postoperative indexes were observed and compared between the two groups.Meanwhile,the incidence of postoperative complications was compared between the two groups.Results The operation time,intraoperative blood loss and incision length in the observation group were better than those in the control group,the difference was statistically significant(P<0.05).VAS scores of the observation group at 3 h,6 h,12 h,and 24 h after surgery were lower than those of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in fasting time and antibacterial treatment time between the observation group and the control group after surgery(P>0.05),but the hospitalization time,intestinal function recovery time,and postoperative exhaust time were shorter than the control group,the difference was statistically significant(P<0.05).The incidence of postoperative complications in the observation group(11.66%)was significantly lower than that in the control group(28.33%),and the difference was statistically significant(χ^(2)=18.532,P=0.011).Conclusion Minimally invasive laparoscopic surgery has good safety in the treatment of acute cholecystitis,improves the efficiency of clinical treatment,and reduces the incidence of complications.