腹腔镜胆囊切除术与小切口开腹胆囊切除术的比较

目的比较腹腔镜胆囊切除术及小切口开腹胆囊切除术的临床应用效果,为更合理地选择手术方案提供参考依据。方法选择天津市武清区人民医院2011年1月至2012年12月收治的97例胆囊疾病患者,50例进行腹腔镜胆囊切除术治疗患者作为A组,47例进行小切口开腹胆囊切除术治疗患者作为B组,比较两组手术方案的应用效果及安全性。结果 A组术中出血量为(62.8±5.4)ml,明显少于B组的(73.1±6.0)ml;A组肠功能恢复时间、下床活动时间及住院时间分别为(16.4±3.7)h、(20.5±5.1)h、(5.2±1.0)d,均明显短于B组的(18.5±4.0)h、(22.9±4.8)h、(6.7±1.4)d,组间比较差异均有统计学意义(P<0.05);A组患者在术后12、48 h血清中的炎症因子白细胞介素-6、C-反应蛋白水平均明显低于B组,组间比较差异均有统计学意义(P<0.05);A组并发症发生率为6.0%,B组为8.5%,组间比较差异无统计学意义(P>0.05);A组用为(9105±230)元,明显高于B组的(8920±197)元,组间比较差异有统计学意义(P<0.05)。结论腹腔镜胆囊切除术及小切口开腹胆囊切除术的临床应用效果均满意,前者创伤小、患者机体应激反应小、康复快,后者治疗费用低,应根据患者的病情及经济能力选择合理的治疗方案。

Comparative study of laparoscopic cholecystectomy and small-incision open cholecystectomy

Objective To compare the clinical application effect of laparoscopic cholecystectomy and small-incision open eholecystectomy, and to provide reference for a more reasonable choice of surgical options. Methods From January 2011 to De- cember 2012, 97 patients with gallbladder disease were selected. Fifty patients in group A were treated by laparoscopic cholecys- tectomy, and 47 patients in group B were treated by small-incision open cholecystectomy, the effect and safety of the two groups were compared. Results The blood loss of group A was （ 62. 8 ± 5.4） ml, significantly less than that of group B [ （ 73.1±6.0） ml] ;The intestinal function recovery time, ambulation time and hospital time of group A were （16.4± 3.7 ）h, （20. 5± 5.1） h, （5.2 ± 1.0） d, significantly shorter than those of group B [ （18.5 ±4. 0） h, （22. 9 ±4. 8） h, （6. 7 ± 1.4） d], the differences were statistically significant （P 〈 0. 05 ） ; The serum levels of IL-6 and CRP of group A at 12, 48 h postoperatively were significantly lower than those of group B, the differences were statistically significant between the two groups （ P 〈 0.05 ） ; The incidence of complications of group A was 6. 0% and 8.5% in group B, the difference was not statistically significant （P 〉 0. 05 ） ; The cost of group A was （9105 ＋ 230） yuan, significantly higher than that of group B [ （8920 ＋ 197） yuan ], the differ- ence was statistically significant （P 〈 0. 05）. Conclusion The clinical effect of laparoscopic cholecystectomy and small-incision open cholecystectomy are satisfied, the former has the advantages of small trauma, stress response and quickly recovery, the latter has lower cost, it should be based on the patient＇ s condition and the economic ability to choose reasonable treatment programs.