腹腔镜术和开腹术治疗急性胆囊炎疗效及安全性分析.docVIP

腹腔镜术和开腹术治疗急性胆囊炎疗效及安全性分析 　　doi：10.3969/j.issn.1007-614x.2014.16.15 　　摘 要 目的：探讨腹腔镜胆囊切除术治疗急性胆囊炎的临床应用价值。方法：2010年6月-2013年12月收治行手术治疗的急性胆囊炎患者129例，回顾性分析其临床资料，按照所行治疗术式不同分为腔镜组69例，行腹腔镜下胆囊切除术治疗和开腹组60例，行常规开腹手术治疗，对两组患者手术相关指标及术后情况进行对比分析。结果：腔镜组手术耗时、术中出血量及术后首次肛门排气时间均明显短于开腹组（P0.01）；腔镜组患者术后切口感染、胆汁漏发生率明显低于开腹组（P0.05）。结论：腹腔镜微创胆囊切除术治疗急性胆囊炎具有出血少、术后并发症少等优势，值得临床推广应用。 　　关键词 腹腔镜手术 开腹手术 急性胆囊炎 　　Efficacy and safety of laparoscopy and laparotomy in the treatment of acute cholecystitis 　　She Mingjie，Liu Xiaohu 　　Department of Hepatobiliary Surgery，the Peoples Hospital of Bozhou City，Anhui 236800 　　Abstract Objective：To investigate the clinical application value of laparoscopy and laparotomy in the treatment of acute cholecystitis.Methods：129 cases with acute cholecystitis who had been treated by operation from June 2010 to December 2013.We retrospectively analyzed their clinical datas.They were divided into the laparoscopy group（69 cases were treated with laparoscopic cholecystectomy） and the open group（60 cases were treated with conventional open operation） according to the different surgical treatment.We analyzed the operation related index and postoperative condition of the two groups.Results：The operation time， amount of bleeding during operation and postoperative anal exhaust time for the first time of the laparoscopic group were significantly shorter than those of the open group（P0.01）.The postoperative incision infection，bile leakage rate of the laparoscopic group were significantly lower than those in the open group（P0.05）.Conclusion：The laparoscopic cholecystectomy in the treatment of acute cholecystitis with less bleeding，less postoperative complications and other advantages，so it is worthy of clinical application. 　　Key words Laparoscopic operation；Open operation；Acute cholecystitis 　　腹腔镜胆囊切除术目前已是治疗慢性胆囊炎的金标准。急性胆囊炎因胆囊水肿、粘连，胆囊三角解剖困难等原因曾一度被认为是腹腔镜胆囊切除手术的禁忌症。但随着腹腔镜手术技术的发展，手术经验大大提高，越来越多的医院在急性胆囊炎治疗中选择腹腔镜胆囊切除。本研究就2010年6月-2013年12月收治的129例急性胆囊炎患者分别行开腹胆囊切除术与腹腔镜胆囊切除术治疗，重点比较两种术式的手术耗时、术中出血量、