摘要
目的探讨早期腹腔镜胆囊切除术(ELC)与延迟腹腔镜胆囊切除术(DLC)治疗轻中型急性胆囊炎的临床价值。方法选取2017年12月至2018年12月期间收治的80例轻中型急性胆囊炎患者(Grade分级:Ⅰ级～Ⅱ级),根据随机数字表法分为ELC组(急性胆囊炎发作≤72 h)与DLC组(急性胆囊炎发作> 72 h)各40例。采用SPSS21. 0统计学软件进行统计分析,术中术后临床指标以平均数±标准差表示,采用独立t检验;术后并发症发生率组间比较采用卡方检验; P <0. 05表示差异具有统计学意义。结果 ELC组与DLC组手术时间、术中出血量、中转开腹率[7. 5%比12. 5%,P=0. 456]、并发症发生率[27. 5%比20. 0%,P=0. 431]差异均无统计学意义; ELC组患者住院时间[(11. 26±1. 65) d比(16. 48±1. 76) d,χ2=2. 164,P=0. 034]短于DLC组患者;两组患者术前,术后1 d、3 d、7 d的白细胞数及中性粒细胞比例差异无统计学意义(P> 0. 05)。结论 ELC治疗轻中型急性胆囊炎与DLC临床治疗效果相当,但是可以缩短住院时间,降低住院成本。
Objective To investigate the clinical value of early laparoscopic cholecystectomy and delayed laparoscopic cholecystectomy in the treatment of mild to medium acute cholecystitis. Methods From December 2017 to December 2018,80 patients with mild and moderate acute cholecystitis(Grade grade:Grade I to grade II)were divided into ELC group(40 cases)(acute cholecystitis≤72 h)and DLC group(40 cases)(acute cholecystitis>72 h).SPSS21.0 statistical software was used to evaluate intraoperative and postoperative clinical indicators.The postoperative clinical indexes were expressed as mean±standard deviation,and independent t test was used for examination.Chi-square test was used to compare the incidence of postoperative complications between two groups. Results There were no significant difference between ELC group and DLC group,in terms of operation time,intraoperative bleeding and the conversion rate of(7.5%vs.12.5%),and incidence of complications of(27.5%vs.20%).The hospitalization of ELC group was shorter than that in DLC group[(11.26±1.65)d vs.(16.48±1.76)d,χ^2=2.164,P=0.034]. There was no significant difference in terms of white blood cell count and neutrophil percentage POD 1 d,3 d and 7 d between the 2 groups before operation(P>0.05). Conclusion ELC is effective in treating mild to medium acute cholecystitis as well as DLC,however it could shorten the length of hospital stay and reduce medical cost.
作者
项建斌
Xiang Jian bin(Department of hepatobiliary surgery,Lu’an People’s Hospital,237000 China)
出处
《中华普外科手术学杂志（电子版）》
2019年第1期54-56,共3页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
首都市民健康项目培育课题(Z131100006813010)~~
关键词
胆囊炎
急性
胆囊切除术
腹腔镜
手术后并发症
成本及成本分析
Cholecystitis,acute
Cholecystectomy,laparoscopic
Postoperative complications
Costs and cost analysis
