不同时期腹腔镜胆囊切除术治疗轻度急性胆管炎的应用分析

Application Analysis of Laparoscopic Cholecystectomy for Mild Acute Cholangitis at Different Periods of Time

目的:分析不同时期腹腔镜胆囊切除术治疗轻度急性胆管炎的应用效果。方法:选取2018年1月—2021年12月天津市公安医院收治的60例轻度急性胆管炎患者作为研究对象,按照手术时期分为早期组30例和延期组30例。早期组于入院后行腹腔镜胆囊切除术,延期组于炎症控制后行腹腔镜胆囊切除术。比较两组患者疗效相关指标;肝功能指标包括:丙氨酸氨基转移酶(ALT)、总胆红素(TBIL);术后视觉模拟疼痛(VAS)评分。结果:早期组患者首次排气时间、术后住院时间长于延期组,差异有统计学意义(χ^(2)=3.475,P<0.05;t=3.107,P<0.05);术后3 d,两组患者ALT、TBIL水平比较,差异无统计学意义(t=0.853、0.361,P>0.05);术后1 h、12 h,早期组患者VAS评分明显低于延期组,差异有统计学意义(t=3.417、5.068,P<0.05)。结论:与早期腹腔镜胆囊切除术比较,延期腹腔镜胆囊切除术更有利于轻度急性胆管炎患者术后恢复,但术后12 h内的疼痛更明显。

Objective:To analyze the application of laparoscopic cholecystectomy for mild acute cholangitis at different periods.Methods:60 patients with mild acute cholangitis admitted to the hospital from January 2018 to December 2021 were selected for the study,and they were divided into the early group(n=30)and the postponed group(n=30)according to the period of surgery.The early group underwent laparoscopic cholecystectomy after admission to the hospital,and the delayed group underwent laparoscopic cholecystectomy after inflammation control.Postoperative visual analog pain(VAS)scores and liver function indices,including alanine aminotransferase(ALT)and total bilirubin(TBIL),were compared between the two groups.Results:Patients in the early group had longer time to first venting and postoperative hospitalization than those in the delayed group,and the difference was statistically significant(χ^(2)=3.475,P<0.05;t=3.107,P<0.05).At 3 d postoperatively,there was no statistically significant difference in ALT and TBIL levels between the two groups(t=0.853,0.361,P>0.05).At 1 h and 12 h postoperatively,the VAS scores of patients in the early group were significantly lower than those in the postponed group,and the differences were statistically significant(t=3.417,5.068,P<0.05).Conclusion:Compared with early laparoscopic cholecystectomy,extended laparoscopic cholecystectomy was more conducive to postoperative recovery in patients with mild acute cholangitis,but pain was more pronounced in the 12 h postoperative period.