摘要
目的探析急性结石性胆囊炎(ACC)患者腹腔镜手术治疗时机的选择对其康复效果的影响.方法回顾性分析2020年8月—2021年7月在该院接受腹腔镜手术治疗的62例ACC患者的临床资料,将发病72 h后行手术治疗的36例患者纳入对照组,将发病72 h内接受治疗的36例患者纳入观察组.比较两组切皮至缝合时间、术中出血量、术后12 h视觉模拟评分(VAS)、术后肛门首次排气时间、术中转开腹率、并发症发生情况及消化病生存质量指数(GLQI)评分.结果观察组切皮至缝合时间及术后肛门首次排气时间均短于对照组,术中出血量少于对照组,术后12 h VAS评分低于对照组,组间差异有统计学意义(P<0.05).观察组术中转开腹率为0.00%,低于对照组的13.89%,差异有统计学意义(P<0.05).观察组并发症发生率为2.78%,与对照组的8.33%相比,差异无统计学意义(P>0.05).出院时,观察组的GLQI评分高于对照组,差异有统计学意义(P<0.05).术后6个月,两组GLQI评分均高于术前,差异有统计学意义(P<0.05),但两组GLQI评分比较,差异无统计学意义(P>0.05).结论ACC发病72 h内实施腹腔镜手术可加快术后康复进程,减轻术后疼痛程度,降低术中转开腹治疗发生率,但手术治疗时机的选择对并发症控制效果及生存质量无显著影响.
Objective To explore the influence of the timing of laparoscopic surgery on the rehabilitation effect of patients with acute calculous cholecystitis(ACC).Methods The clinical data of 62 patients with ACC who underwent laparoscopic surgery in the hospital from August 2020 to July 2021 were retrospectively analyzed.36 patients who received surgical treatment after 72 hours of onset were included in the control group,and 36 patients who received treatment within 72 hours of the onset were included in the observation group.The time from skin incision to suture,intraoperative blood loss,visual analogue scale(VAS)at 12 hours after operation,time to first anal exhaust after operation,intraoperative conversion to laparotomy rate,incidence of complications and gastrointestinal quality of life index(GLQI)score were compared between the two groups.Results The time from skin incision to suture and the first postoperative anal exhaust time in the observation group were shorter than those in the control group,the intraoperative blood loss was less than that in the control group,and the VAS score at 12 h after operation was lower than that in the control group,and the differences between the groups were statistically significant(P<0.05).The rate of intraoperative conversion to laparotomy in the observation group was 0.00%,which was lower than 13.89%in the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the observation group was 2.78%,which was not statistically significant compared with 8.33%in the control group(P>0.05).At the time of discharge,the GLQI score of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).At 6 months after operation,the GLQI scores of the two groups were higher than those before operation,and the difference was statistically significant(P<0.05),but there was no significant difference in the GLQI scores between the two groups(P>0.05).Conclusion Laparoscopic surgery within 72 hours
作者
张志德
ZHANG Zhide(Department of Gastrointestinal Surgery,Shandan County People's Hospital,Zhangye City,Gansu Province,Shandan Gansu,734100,China)
出处
《反射疗法与康复医学》
2022年第16期126-129,共4页
Reflexology And Rehabilitation Medicine
关键词
急性结石性胆囊炎
腹腔镜手术
治疗时机
康复效果
生存质量
Acute calculous cholecystitis
Laparoscopic surgery
Timing of treatment
Rehabilitation effect
Quality of life
