腹腔镜下胆囊切除术治疗急性胆囊炎的最佳时机分析

目的:探讨腹腔镜下胆囊切除术治疗急性胆囊炎的最佳时机。方法:选取80例急性胆囊炎患者为研究对象,按照随机数字表法分为A、B、C、D组,每组20例。A组在发病后48 h内实施手术,B组在发病后48~72 h内实施手术,C组在发病72 h后实施手术,D组先实施保守治疗,在症状缓解2~4周后实施择期手术。比较4组手术相关指标水平及并发症发生率。结果:A组手术出血量及术后腹腔引流量明显少于另3组,手术时间明显短于另3组,差异有统计学意义(P<0.05);四组并发症发生率比较,差异无统计学意义(P>0.05)。结论:急性胆囊炎发病后48 h内手术出血及创伤较小,手术时间短,且安全性高,可作为腹腔镜下胆囊切除术实施的最佳手术时机。

Analysis of optimal timing of laparoscopic cholecystectomy for acute cholecystitis

Objective:To explore optimal timing of laparoscopic cholecystectomy for acute cholecystitis.Methods:80 patients with acute cholecystitis were selected as the research subjects,and were divided into four groups according to the random number table method:group A(n=20,the surgery was performed within 48 hours after onset),and group B(n=20,the surgery was performed within 48 to 72 hours after onset),group C(n=20,the surgery was performed 72 hours after onset),group D(n=20,elective surgery was performed 2 to 4 weeks after symptom relief through conservative treatment).Then,the levels of surgery-related indicators and the incidence of complications were compared among the four groups.Results:The blood loss and drainage volume of group A were significantly less than those of the other three groups,the operation time was significantly shorter than those of the other three groups,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications among the four groups(P>0.05).Conclusions:The surgery performed within 48 hours after acute cholecystitis onset has less blood loss and trauma and has shorter operation time with good safety.Therefore,it can be used as the optimal time for laparoscopic cholecystectomy.