急性结石性胆囊炎腹腔镜胆囊切除术时机选择及中转开腹影响因素研究.docVIP

急性结石性胆囊炎腹腔镜胆囊切除术时机选择及中转开腹影响因素研究.doc

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急性结石性胆囊炎腹腔镜胆囊切除术时机选择及中转开腹影响因素研究

急性结石性胆囊炎腹腔镜胆囊切除术时机选择及中转开腹影响因素研究   [摘要] 目的 探讨采用腹腔镜胆囊切除术对急性结石性胆囊炎患者治疗的最佳时机选择及影响中转开腹的因素。 方法 回顾性分析2009年3月~2013年5月来我院进行治疗的288例急性结石性胆囊炎患者的临床资料,按照患者从症状发作到接受手术的时间进行分组,Ⅰ组93例患病时间在48 h内,Ⅱ组86例患病介于48~72 h之间,Ⅲ组66例患病超过72 h,Ⅳ组43例患者择期手术。 结果 四组术后并发症发生率不具有显著性差异(P0.05)。Ⅱ组、Ⅲ组、Ⅳ组中转开腹率高于Ⅰ组,手术时间长于Ⅰ组(P48 h的患者具有较高的中转开腹率(P0.05)。白细胞计数及手术时机为腹腔镜胆囊切除术中转开腹的影响因素(P0.05)。 结论 症状发作后48 h内为急性结石性胆囊炎患者采用腹腔镜胆囊切除术的最佳时机,影响中转开腹的两个独立危险因素为白细胞计数及手术时机的选择。   [关键词] 胆囊炎;腹腔镜;胆囊切除术;手术时机;中转开腹   [中图分类号] R657.4 [文献标识码] B [文章编号] 1673-9701(2013)34-0023-03   The research of opportunity selection and the influence factors of conversion to open laparotomy in acute calculous cholecystitis laparoscopic cholecystectomy   LIU Zhuowen1 XU Guoqiang2   1.Department of General Surgery, Yinzhou Second Hospital of Ningbo City in Zhejiang Province, Ningbo 315192, China; 2.Department of Gastroenterology, the First Hospital Affiliated to Zhejiang University, Hangzhou 310003, China   [Abstract] Objective To investigate the best chance of selection and factors that affect conversion to open laparotomy of laparoscopic cholecystectomy for acute calculous cholecystitis patients. Methods The clinical data of 288 cases with acute calculous cholecystitis selected from March 2009 to May 2013 in our hospital were retrospective analyzed, all subjects were performed laparoscopic cholecystectomy. They were grouped according to the time from symptom onset to surgery, there were 93 cases in Ⅰ group and the set time within 48 h, there were 86 cases in Ⅱ group and the set time 48 to 72 h, there were 66 cases in Ⅲ group and the set time more than 72 h, there were 43 cases in the IV group and they were underwent elective surgery. Results There were no significant difference in the postoperative complication rate among four groups (P0.05). Conversion to open laparotomy rate of Ⅱ group, Ⅲ group, Ⅳ group were higher than in group I, operation time were longer than group Ⅰ (P 48 h patients had higher conversion to open laparotomy rate (P   [Key words] C

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