王敬

[摘要] 目的 探討早期腹腔镜胆囊切除术治疗急性非结石性胆囊炎的效果。 方法 选取本院2017年3月～2019年3月普外科收治的急性非结石性胆囊炎患者85例，根据随机数字表法将患者分为对照组42例及观察组43例，对照组采用开腹手术，观察组给予腹腔镜胆囊切除术，观察两组患者的术后情况、并发症、炎症因子情况及术后胃肠道功能恢复情况。 结果 观察组手术时间及住院时间与对照组相比显著缩短，术后首次排便时间及术中出血量显著减少，差异有统计学意义（P<0.05）。观察组术后TNF-α、IL-8、CRP及血清淀粉酶水平显著低于对照组，两组比较差异均有统计学意义（P均<0.05）。观察组患者并发症总发生率为6.99%，显著低于对照组的21.42%，差异有统计学意义（P<0.05）。观察组患者的术后胃肠道功能恢复情况明显优于对照组，两组比较差异显著（P<0.05）。结论 早期腹腔镜胆囊切除术治疗急性非结石性胆囊炎临床疗效显著，术后各项指标恢复较快，可明显降低术后并发症的发生率，术后炎症因子对机体的影响明显减轻，值得临床推广应用。

[关键词] 早期腹腔镜胆囊切除术;开腹手术;非结石性胆囊炎;并发症

[中图分类号] R657.4          [文献标识码] B          [文章编号] 1673-9701（2020）16-0043-04

Effect of early laparoscopic cholecystectomy on acute noncalculious cholecystitis

WANG Jing

Department of Surgery， Donggang Traditional Chinese Medicine Hospital in Liaoning Province， Donggang   118300， China

[Abstract] Objective To explore the effect of early laparoscopic cholecystectomy on acute noncalculus cholecystitis. Methods A total of 85 patients with acute noncalculious cholecystitis treated in our hospital from March 2017 to March 2019 were selected. All patients were divided into control group（n=42） and observation group（n=43） according to the random number table. The control group was treated with open surgery. The observation group was given laparoscopic cholecystectomy. The postoperative conditions， complications， inflammatory factors and postoperative gastrointestinal function recovery in the two groups were observed. Results Compared with that of the control group， the operation time and hospital stay in the observation group was significantly shortened， and the time of first defecation and the amount of intraoperative blood loss was significantly reduced， with significant difference（P<0.05）. The levels of TNF-α， IL-8， CRP and serum amylase in the observation group were significantly lower than those in the control group after operation， and the differences between the two groups were statistically significant（P<0.05）. The total incidence of complications in the observation group was 6.99%， which was significantly lower than 21.42% in the control group， and the difference was statistically significant（P<0.05）. The postoperative gastrointestinal function recovery of the observation group was significantly better than that of the control group， and the difference between the two groups was significant（P<0.05）. Conclusion Early laparoscopic cholecystectomy is effective in the treatment of acute noncalculus cholecystitis. The recovery of various indicators after surgery is fast. It can significantly reduce the incidence of postoperative complications. The effect of postoperative inflammatory factors on the body is significantly reduced. It is worthy of clinical application.

[Key words] Early laparoscopic cholecystectomy; Open surgery; Noncalculus cholecystitis; Complications

非结石性急性胆囊炎具有具有较高的临床发生率，患者胆囊其诱发因素比较复杂，但胆囊内并不存在结石[1-2]。非结石性急性胆囊炎发病快，如不及时治疗易出现坏疽，进而穿孔，病情十分危急。以往治疗该疾病的有效方法是手术，但對于老年患者来说，手术作为创伤性治疗，出血量多，并发症发生率比较高，严重影响患者的恢复及预后，因此临床上降低手术创伤对促进患者术后预后具有重要的作用[3-4]。近年来，腹腔镜胆囊切除手术更多的用于胆囊炎的治疗中，因其操作时间短、恢复快，术后康复较好，而受到广大患者的欢迎。本研究主要探讨早期腹腔镜胆囊切除术治疗急性非结石性胆囊炎的效果，现报道如下。

1 资料与方法

1.1 一般资料

选取本院2017年3月～2019年3月普外科收治的急性非结石性胆囊炎患者85例，临床主要表现为右上腹痛，体温升高，同时伴恶心呕吐等。……