孙海光

[摘要] 目的 比较分析腹腔镜与开腹手术治疗急性结石性胆囊炎的临床疗效。 方法 计算机随机检索300例2012年3月—2016年3月期間在该院的急性结石性胆囊炎患者资料，随机分为试验组（150例）和对照组（150例）。进行传统开腹手术的为对照组患者，进行腹腔镜手术为实验组患者，观察比较两组患者的手术过程中指标、术后指标，以总结比较两种手术的临床疗效。结果 试验组的手术时间（42.0±7.6）min显著优于对照组（83.3±8.0）min；试验组的术中出血量（32.3±5.6）mL显著优于对照组（70.0±7.0）mL；试验组的止痛药使用率（10.00%）显著优于对照组（38.00%）；试验组的VAS评分（2.2±0.6）分显著优于对照组（15.0±5.0）分；试验组的平均住院时间（4.3±1.6）d显著优于对照组（15.0±5.0）d；试验组的并发症发生率（3.33%）显著优于对照组（16.67%）；排气时间上比较，对照组（38.3±4.8）min多于试验组（22.0±3.6）min，差异有统计学意义（P<0.05）。 结论 急性结石性胆囊炎患者采用腹腔镜治疗，有显著的效果，降低了并发症的发生率，创伤小，出血量少，住院时间短，提高了患者的生活质量。

[关键词] 腹腔镜；开腹手术；治疗；急性结石性胆囊炎

[中图分类号] R65 [文献标识码] A [文章编号] 1674-0742（2017）06（b）-0095-03

[Abstract] Objective To compare and analyze the clinical curative effect of laparoscopic surgery in treatment of acute calculous cholecystitis. Methods 300 cases of patients with acute calculous cholecystitis admitted and treated in our hospital from March 2012 to March 2016 were selected and randomly divided into two groups with 150 cases in each， the control group and the experimental group were respectively treated with traditional laparotomy and laparoscopic surgery， and the indexes in operation and after operation were compared between the two groups and the clinical curative effect of the two groups was summarized. Results The operation time in the test group was obviously better than that in the control group， [（42.0±7.6）min vs （83.3±8.0）min]， and the intraoperative bleeding amount in the test group was obviously better than that in the control group， [（32.3±5.6）mL vs （70.0±7.0）mL]， and the use rate of pains relief in the test group was obviously better than that in the control group（10.00% vs 38.00%）， and the VAS score in the test group was obviously better than that in the control group[（2.2±0.6）points vs （2.2±0.6）points]， and the average length of stay and incidence rate of complications in the test group were obviously better than those in the control group，[（4.3±1.6）d， 3.33% vs （15.0±5.0）d， 16.67%]， and the exhaust time in the control group was more than that in the test group[（38.3±4.8）min vs （22.0±3.6）min]， and the difference was statistically significant（P<0.05）. Conclusion The effect of laparoscopic surgery in treatment of acute calculous cholecystitis is obvious， which can reduce the incidence rate of complications with small trauma， less bleeding amount and short length of stay and improve the quality of life.

[Key words] Laparoscopy； Laparotomy； Treatment； Acute calculous cholecystitis

随着社会的不断发展与进步，人们的生活质量与生活水平都在提高。现代化社会，人们的生活节奏快，给人们造成的生活压力与心理压力都非常大[1]。根据调查发现，患有肠胃疾病的患者在逐年增加，严重影响到患者的家庭幸福与日常生活，这一问题已经受到了社会广泛的关注[2]。急性结石性胆囊炎采用传统开腹手术治疗，手术难度大。传统的治疗肠胃疾病需要进行手术治疗，术后创面大，出血量多，身体恢复时间较长，影响患者工作以及生活，护理不当还会造成感染[3]。为了探究更好的治疗方法，随机选取300例急性结石性胆囊炎于2012年3月—2016年3月期间在该院经诊就诊的患者为研究对象，该院特对腹腔镜与传统开腹手术治疗急性结石性胆囊炎患者的疗效进行分析探讨，现报道如下。……