腹腔镜和开腹胆囊切除术治疗慢性胆囊炎急性发作疗效分析

目的 对腹腔镜胆囊切除术和开腹胆囊切除术治疗慢性胆囊炎急性发作的疗效及术后恢复和并发症情况进行比较分析.方法 选取2011年1月至2014年1月我院收治的慢性胆囊炎急性发作患者90例,其中行开腹胆囊切除术（OC组）治疗45例,行腹腔镜胆囊切除术治疗（LC组）45例.所选患者均为急性发作72 h内,经B超或CT检查确诊.两组患者分别采用开腹胆囊切除术和腹腔镜胆囊切除术治疗,观察两组患者手术时间、术中出血量、切口长度、患者住院时间及费用、术后疼痛持续时间、肛门排气时间和术后开始床下活动时间;术后并发症情况,包括感染、腹腔出血、肠道粘连、肺部感染以及胆管损伤等.结果 LC组手术时间、术中出血量以及切口长度均显著小于OC组（P＜0.01）;LC组患者术后住院时间及费用、术后疼痛持续时间、肛门恢复排气时间和开始下床活动时间均显著少于OC组（P＜0.01）;两组患者并发症发生情况比较无显著差异.结论 腹腔镜胆囊切除术治疗慢性胆囊炎急性发作疗效较好,创伤较小,术后恢复快,患者的经济负担小,值得临床推广.

Efficacy Analysis of Laparoscopic and Open Cholecystectomy in the Treatment of Chronic Cholecystitis in Acute Exacerbation

OBJECTIVE To analyse postoperative recovery and complications in acute exacerbation of chronic cholecystitis by the ther- apy of laparoscopie cholecystectomy and open eholecystectomy. METHODS 90 cases chronic cholecystitis patients in acute exacerba- tion in our hospital from January 2011 to January 2014 were selected. 45 cases of which were given open cholecystectomy（OC） treat- ment, 45 cases were given laparoscopic cholecystectomy（LC）. The selected patients were acute exacerbation within 72h, and were diag- nosed by B ultrasound or CT . Observed indicators were： the length of operation time, blood loss, length of incision, hospitalization time and costs, duration of postoperative pain, anal exhaust time, beginning activity time off bed. postoperative complications, includ- ing infections, abdominal bleeding, intestinal adhesions, lung infection and bile duct injury.RESULTS： Length of operation time, the amount of blood loss and incision length in LC group was significantly smaller than that in OC group（P〈0.01）; postoperative hospital- ization time and expense of patients, the duration of postoperative pain, anal exhaust time, and beginning activity time off bed in LC group were significantly less compared with OC group（P〈0.01）; complications in two groups were not significantly different.CONCLU- SION： laparoscopie choleeystectomy in the treatment of chronic cholecystitis in acute exacerbation has better effect , less trauma, quicker recovery, small economic burden of the patients, is worthy being popularized in clinic.