李鹤泉

[摘要] 目的 探究急性结石性胆囊炎患者不同时机采取腹腔镜胆囊切除术治疗的临床效果。方法 方便选取该院2017年2月—2019年8月接收的60例行腹腔镜胆囊切除术治疗的急性结石性胆囊炎患者均分成3组，A组病情发作24 h内实施手术，B组病情发作24～72 h实施手术，C组病情发作≧72 h实施手术。比较3组手术指标、术后并发症与生活质量。结果 A组与B组各项手术指标均优于C组，3组术后生活质量评分均高于术前，差异有统计学意义（P<0.05）;A组术后并发症发生率为5.00%（1/20），B组为10.00%（2/20），C组为15.00%（3/20）;由此可见，3组并发症发生率均，差异无统计学意义（P>0.05）。结论 急性结石性胆囊炎患者病情发作72 h内采取腹腔镜胆囊切除术效果确切，能改善临床预后，提高生活质量，值得采纳。

[关键词] 急性结石性胆囊炎;腹腔镜胆囊切除术;临床预后;并发症;治疗效果

[中图分类号] R657          [文献标识码] A          [文章编号] 1674-0742（2020）06（a）-0028-03

The Effect and Prognosis of Laparoscopic Cholecystectomy for Acute Stone Cholecystitis at Different Timings

LI He-quan

Department of General Surgery， Fengxian Traditional Chinese Medicine Hospital， Fengxian， Jiangsu Province， 221700 China

[Abstract] Objective To explore the clinical effect of laparoscopic cholecystectomy in patients with acute stone cholecystitis at different times. Methods Sixty patients with acute calculus cholecystitis who underwent laparoscopic cholecystectomy in our hospital from February 2017 to August 2019 were convenient selection divided into three groups. Group A had surgery within 24 hours of the onset of illness， and group B had an onset of illness. Surgery was performed from 24 to 72 hours， and surgery was performed in group C≥72 hours. The three groups were compared for surgical indicators， postoperative complications， and quality of life. Results The surgical indexes of group A and group B were better than those of group C. The postoperative quality of life scores in the three groups were higher than before surgery（P<0.05）， which was statistically significant; the incidence of postoperative complications in group A was 5.00%（1/20）， group B was 10.00% （2/20）， group C was 15.00% （3/20）; it can be seen that there was no statistically significant difference in the incidence of complications in the three groups（P>0.05）， no statistics significance. Conclusion The effect of laparoscopic cholecystectomy within 72 hours of the onset of the disease in patients with acute stone cholecystitis is definite， it can improve the clinical prognosis， improve the quality of life， and it is worth adopting.

[Key words] Acute stone cholecystitis; Laparoscopic cholecystectomy; Clinical prognosis; Complications; Treatment effect

急性結石性胆囊炎为临床外科急腹症[1]，是因结石阻塞胆囊管，造成胆汁滞留，进而继发细菌感染引起的，患者临床表现主要为急性上腹部疼痛感、呕吐恶心等，若治疗不及时，将有可能引起胆囊穿孔、坏疽等[2]，增加临床治疗的难度。腹腔镜胆囊切除术是治疗急性结石性胆囊炎的主要术式，因其具有切口小、创伤轻及恢复快速等优点[3]，故被广泛用于临床中，但手术时机的选择依旧存在一定争议。方便选取该院于2017年2月—2019年8月收治的60例急性结石性胆囊炎患者作为研究对象，针对该课题进行研究，报道如下。

1  资料与方法

1.1  一般资料

研究方便选取的60例患者经临床诊断均确诊为急性结石性胆囊炎，均分成3组，A组男女之比为13：7;年龄25～70岁，平均（50.25±5.47）岁;结石直径0.5～2 cm，平均（4.96±1.47）cm。……