腹腔镜下急性结石性胆囊炎手术时机探讨 蒋光华.docVIP

精品论文 参考文献 腹腔镜下急性结石性胆囊炎手术时机探讨 蒋光华 湖南省怀化市溆浦县低庄镇中心卫生院 419306 【摘 要】目的：对腹腔镜进行急性结石性胆囊炎手术进行分析研究，找寻最佳的手术时机。方法：选取我院在2013年6月——2014年10月期间所接收的90例急性结石性胆囊炎患者，按照发病到手术的时间间隔为标准，在＜48h之内的36例患者分入A组，在48—72h之间的32例患者分入B组，将时间＞72h的22例患者分入C组；对所有患者在腹腔镜下进行胆囊切除的常规手术，对患者的手术完成效果、手术持续时间、术中出血量、住院天数以及并发症情况进行对比分析。结果：通过比较，发现C组患者的中转开腹率为50％，明显高于A组和B组的2.78％、12.5％（P＜0.05）；且C组患者的术中出血量和手术持续时间分别为61.9plusmn;11.6ml和65.8plusmn;12.4min，与A组患者相比差异较明显（P＜0.05）；C组患者出现肠瘘、胆漏和腹腔感染的概率分别为45.45％、31.82％以及40.91％，明显高于A组和B组的患者（P＜0.05）；且A、B两组患者在胆漏和腹腔感染的比较上不具有统计学意义（P＞0.05）。结论：对于急性结石性胆囊炎患者而言，在病发48h之内对其进行腹腔镜手术是最佳时机，具有较好的效果；在病发超过72h之后才进行手术的时候，需要予以高度的重视。 【关键词】腹腔镜；急性结石性胆囊炎；手术时机 Abstract：Purpose：to acute calculous cholecystitis laparoscopic surgery carries on the analysis research，looking for the best operation time.Selection methods：our hospital in June 2013，October 2014 received during the period of 90 cases of acute calculous cholecystitis patients，according to the time interval of onset to surgery as the standard，in lt; within 48 h of 36 patients in group A，between 48-72 h of 32 patients were drawn in group B，the time gt; 72 h 22 patients were drawn in group C；Gallbladder in laparoscopic resection in patients with all conventional surgery，surgery of the patients with complete effect，duration of surgery，intraoperative blood loss，hospitalization days and complications were analyzed.Results：through the comparison，found that patients transfer laparotomy group C at A rate of 50%，significantly higher than that of group A and group B were 2.78%，12.5%（P lt; 0.05）；And C group of patients with intraoperative blood loss and duration of surgery were 61.9 + / - 11.6 ml and 65.8 + / - 12.4 min，compared with A group of patients with obvious difference（P lt; 0.05）；C group of patients with intestinal fistula，the probability of bile leak and abdominal infection were 45.45%，31.82% and 40.91%，significantly higher than the patients in group A and group B（P lt; 0.05）；And A，B two groups of patients in the comparison of bile leak and abdominal infect