摘要
目的分析急性胆囊炎的手术治疗时机选择以及其对于并发症发生率的作用。方法将该院2017年1—12月所收治的68例急性胆囊炎患者作为该次研究的对象,然后将其按照症状发生至行腹腔镜胆囊切除术时间分为观察组与对照组,每组34例。患者在术前进行细致检查,特别是对于某些老年患者需要准确掌握其病史和脏器功能情况。综合代谢结果与生化检查结果,根据患者状态给予静脉营养供给,注重水平衡与电解质平衡,预防性使用抗生素,行腹腔镜下胆囊切除术。观察组为早期治疗组,在48 h内进行,对照组为延期治疗组,在48 h后进行手术,手术结束后比较两组患者出现的胆道损伤、胆漏、出血、肺部感染并发症状况进行统计。结果研究结果表明,观察组出现了1例出血、2例肺部感染;而对照组出现了1例胆道损伤、2例胆漏、3例出血与2例肺部感染,在并发症发生率上观察组的8.8%也要优于对照组的23.5%,并发症发生率差异有统计学意义(χ^2=4.506,P=0.012)。结论急性胆囊炎行早期腹腔镜下手术可以显著降低并发症的发生率,更好地促进患者的预后恢复进度,具有重要的临床价值。
Objective To analyze the timing of surgical treatment for acute cholecystitis and its effect on the incidence of complications.Methods A total of 68 patients with acute cholecystitis admitted to our hospital from January to December 2017 were selected as the subjects of this study.They were divided into observation group and control group according to the time of symptomatic laparoscopic cholecystectomy,with 34 patients in each group.Patients should be carefully examined before surgery,especially for the elderly patients who need to accurately grasp their medical history and organ function.Considering the results of comprehensive metabolism and biochemical examination,intravenous nutrition was given according to the patient's state.Water balance and electrolyte balance were emphasized,preventive antibiotics were used,and laparoscopic cholecystectomy was performed.The observation group was the early treatment group,which was carried out within 48h,and the control group was the delayed treatment group,which was operated after 48 h.After the operation,the complications of biliary tract injury,bile leakage,bleeding and pulmonary infection were compared between the two groups for statistical analysis.Results There was 1 case of hemorrhage and 2 cases of pulmonary infection in the observation group.In the control group,1 case of biliary tract injury,2 cases of biliary leakage,3 cases of bleeding and 2 cases of pulmonary infection occurred.The incidence of complications in the observation group was 8.8%,which was also better than that in the control group(23.5%),the difference was statistically significant(χ^2=4.506,P=0.012).Conclusion Early laparoscopic surgery for acute cholecystitis can significantly reduce the incidence of complications and better promote the prognosis and recovery of patients,which has important clinical value.
作者
牛作平
张素贞
NIU Zuo-pin;ZHANG Su-zhen(Department of General Surgery,Dingtao District People's Hospital of Heze City,Dingtao,Shandong Province,274100 China;Department of Gastroenterology,Dingtao District People's Hospital of Heze City,Dingtao,Shandong Province,274100 China)
出处
《系统医学》
2019年第12期92-94,共3页
Systems Medicine
关键词
急性胆囊炎
手术治疗
时机选择
并发症发生
作用研究
Acute cholecystitis
Surgical treatment
Timing
Complications occurrence
Action research
