腹腔镜胆囊切除术与开腹胆囊切除术对胃肠动力恢复的影响

目的探讨腹腔镜与开腹胆囊切除术后的临床疗效及胃肠动力的恢复情况。方法分析我院2011年1月～2013年1月收治的行胆囊切除术患者174例,其中行腹腔镜胆囊切除术患者84例,开腹胆囊切除术90例。比较两组术后切口长度、术中出血量和手术时间、止痛药使用例数、术后下床时间和住院时间、肠鸣音恢复时间及肛门排气时间及不良反应发生情况。结果①两组治疗后切口长度、术中出血量和手术时间、止痛药使用例数、术后下床时间和住院时间比较,腹腔镜组均低于开腹组（P〈0.05）。②两组患者肠鸣音恢复时间、肛门排气时间比较,腹腔镜组均低于开腹组（P〈0.05）。③两组发热发生率比较,腹腔镜组低于开腹组（P〈0.05）;胆管损伤、胆汁漏、肠粘连、切口感染发生率比较（P〉0.05）。结论腹腔镜胆囊切除术后患者胃肠动力恢复快,且不增加不良反应发生率,值得临床推广应用。

The influence on gastrointestinal motility recovery after laparoscopic cholecystectomy and open cholecystectomy

Objective To evaluate the clinical effect and recovery on gastrointestinal motility after laparoscopic and open cholecystectomy.Methods A total of 174 patients of cholecystectomy in our hospital from January 2011 to January 2013 were analyzed.84 patients were treated by laparoscopic cholecystectomy.90 patients were treated by open cholecystectomy.The length of incision,intraoperative bleeding,operation time,the cases of analgesic use,the postoperative time of get out of bed,length of stay,the time of bowel sound recovery,anal exhaust time and the incidence of adverse reactions were compared between two groups after treatment.Results（1） The length of incision,intraoperative bleeding,operation time,the cases of analgesic use,the postoperative time of get out of bed,length of stay in laparoscopic group after treatment were lower than the open group（P0.05）.（2）The bowel sound recovery time,anal exhaust time and the incidence of adverse reactions in the laparoscopic group were lower than the open group（P0.05）.（3）The incidence of fever in laparoscopic group was lower than the open group（P0.05）;The incidence rates of bile duct injury,leakage,intestinal adhesion and wound infection between two groups were not statistically significant（P 0.05）.Conclusion Patients of gastrointestinal motility have rapid recuperation after laparoscopic cholecystectomy.Laparoscopic cholecystectomy does not increase the incidence of adverse reactions,it is worthy of clinical application.