赵振军 江祖德

[摘要] 目的 分析腹腔镜与传统开腹手术治疗急性结石性胆囊炎的临床效果。 方法 选取2011年1月～2014年12月在医院诊治的80例急性结石性胆囊炎患者进行试验观察，将其分为观察组与对照组，每组40例。观察组采用腹腔镜手术治疗；对照组采用传统开腹手术治疗。比较两组患者的手术时间、术中出血量、镇痛药物使用量、疼痛评分、肛门排气时间、下床活动时间、并发症发生率。 结果 观察组和对照组患者的手术时间分别为（82.5±10.8）、（98.6±15.3）min；术中出血量为（42.1±7.2）、（86.4±13.6）ml，镇痛药物使用量为（116.2±7.6）、（175.5±21.3）mg，VAS疼痛分数为（2.8±0.7）、（5.0±0.9）分，肛门排气时间为（29.4±8.7）、（62.4±13.2）h，下床活动时间为（13.4±6.1）、（26.2±8.5）h，两组比较差异有统计学意义（P<0.05）。观察组并发症发生率低于对照组，两组比较差异有统计学意义（P<0.05）。 结论 腹腔镜手术治疗急性结石性胆囊炎与传统开腹手术比较，具有手术时间短、出血量少、术后预后好、对患者身体的损伤较小等优势，有助于改善患者的生活质量，值得临床推广应用。

[关键词] 腹腔镜手术；传统开腹手术；急性结石性胆囊炎

[中图分类号] R575.6+1 [文献标识码] A [文章编号] 1674-4721（2016）02（b）-0032-03

Analysis the clinical effects of laparoscope and traditional open surgery in treating acute calculous cholecystitis

ZHAO Zhen-jun JIANG Zu-de

Department of General Surgery，the Eighth People′s Hospital of Dongguan City in Guangdong Province，Dongguan 523325，China

[Abstract] Objective To analyze the clinical effects of laparoscope and traditional open surgery in treating acute calculous cholecystitis. Methods 80 patients with acute calculous cholecystitis from January 2011 to December 2014 of our hospital were selected and were divided into control group and observation group，each group was 40 cases.Patients in observation group were used laparoscope and patients in control group were used traditional open surgery.The operation time，bleeding volume during operation，analgesics usage，pain score，anus exhaust time and time to leave bed between two groups were compared. Results The operation time between observation group and control group was respectively（82.5±10.8）min and （98.6±15.3） min；Bleeding volume during operation between two groups was respectively（42.1±7.2）ml and （86.4±13.6） ml；Analgesics usage between two groups was respectively （116.2±7.6）mg and （175.5±21.3）mg；VAS pain score between two groups was respectively （2.8±0.7） scores and （5.0±0.9） scores；Anus exhaust time between two groups was respectively （29.4±8.7）h and （62.4±13.2）h；Time to leave bed between two groups was respectively（13.4±6.1）h and （26.2±8.5）h，and the difference had statistical significance（P<0.05）.The incidence rate of complication in observation group was lower than that of control group，with statistical difference（P<0.05）. Conclusion Compared with traditional open surgery，laparoscope in treating acute calculous cholecystitis has advantages in less operation time and bleeding，high prognosis after operation and less damage to patients′ body.It is helpful to improve the life quality of patients and is worth to popularize in clinic.

[Key words] Laparoscope surgery；Traditional open surgery；Acute calculous cholecystitis

急性结石性胆囊炎是一种肝胆外科疾病，主要是胆囊管结石，胆汁阻塞，胆汁滞留胆囊内造成继发性细菌感染的疾病，其多发于女性群体[1]。该病的常见临床症状为右上腹剧烈疼痛、恶心、呕吐、高热等，部分患者由于感染严重出现全身性症状[2]。急性结石性胆囊炎的临床治疗主要有保守治疗和手术治疗，保守治疗的效果不理想，不能改善患者的结石症状，且可能导致患者出现胰腺炎和癌变等现象[3]。因此，临床一般采用胆囊切除术为能接受手术的患者进行治疗，其中腹腔镜手术治疗效果较好。

1 资料与方法

1.1 一般资料

选取2011年1月～2014年12月在医院诊治的80例急性结石性胆囊炎患者进行试验观察，将其分为观察组与对照组，每组40例。……