早期腹腔镜胆囊切除术与延迟腹腔镜胆囊切除术治疗急性胆囊炎的临床效果比较

Comparison of Clinical Effect of Early Laparoscopic Cholecystectomy versus Delayed Laparoscopic Cholecystectomy in Treatment of Acute Cholecystitis

目的:比较早期腹腔镜胆囊切除术与延迟腹腔镜胆囊切除术治疗急性胆囊炎的临床效果。方法:选取2019年1月—2022年12月菏泽市东明县人民医院收治的71例急性胆囊炎患者作为研究对象,随机分为早期组(n=37)与延期组(n=34)。早期组患者于入院<3 d行腹腔镜胆囊切除,延期组患者住院后进行抗炎治疗,炎症消失后6~8周进行胆囊切除术。比较两组治疗效果。结果:早期组手术时间、住院时间短于延期组,肠胃功能恢复时间早于延期组,术中出血量少于延期组,差异有统计学意义(P<0.05)。术后1 h,两组疼痛评分比较,差异无统计学意义(P>0.05);术后12 h,两组疼痛评分高于术后1 h,但早期组低于延期组,差异有统计学意义(P<0.05);术后24 h,两组疼痛评分低于术后12 h,且早期组低于延期组,差异有统计学意义(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论:相较于延迟腹腔镜胆囊切除术,早期腹腔镜胆囊切除术治疗急性胆囊炎的效果更好,可缩短手术时间,减少术中出血量,促进康复,减轻患者术后疼痛,且安全性较高。

Objective:To compare the clinical effect of early laparoscopic cholecystectomy and delayed laparoscopic cholecystectomy in the treatment of acute cholecystitis.Methods:A total of 71 patients with acute cholecystitis admitted to Dongming County People's Hospital of Heze City between January 2019 and December 2022 were selected as the study subjects.They were randomly divided into early group(n=37)and delayed group(n=34).Patients in the early group underwent laparoscopic cholecystectomy within 3 d of admission,and patients in the delayed group underwent anti-inflammatory treatment after hospitalization and received cholecystectomy at 6-8 weeks after the symptoms disappeared.The treatment effects of the two groups were compared.Results:The operation time and the length of hospital stay in the early group were shorter than those in the delayed group,the recovery time of gastrointestinal function in the early group was earlier than that in the delayed group,the intraoperative blood loss in the early group was less than that in the delayed group,and the difference was statistically significant(P<0.05).At 1 h after surgery,there was no significant difference in pain scores between the two groups(P>0.05);At 12 h after surgery,the pain scores in the two groups were higher than those at 1 h after surgery,but the pain scores in the early group were lower than those in the delayed group,with a statistically significant difference(P<0.05);At 24 h after surgery,the pain scores in the two groups were lower than those at 12 h after surgery,and the pain scores in the early group were lower than those in the delayed group,with a statistically significant difference(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion:Compared with delayed laparoscopic cholecystectomy,early laparoscopic cholecystectomy has a better effect in the treatment of acute cholecystitis,which can shorten the operation time,reduce the intraoperative blood loss,promote recovery,reduce postoperative pain of patients,and have high safety.