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目的探究腹腔镜胆囊切除术不同手术时机的选择对急性胆囊炎患者康复效果的影响。方法选取2013年4月—2014年10月收治确诊的84例急性胆囊炎患者,采用随机数表法分为2组,其中24例采用传统开腹胆囊切除术治疗记为对照组,另60例采用腹腔镜胆囊切除术治疗记为观察组,比较两组治疗效果;将观察组进一步细分为A、B2组,两组各30例,A组于发病3d内行手术治疗,B组于3d后行手术,进一步分析2组不同手术时机选择对患者康复的影响。结果观察组手术时间(62.4±18.7)min、术中出血量(74.3±22.4)ml、术后12h VAS(2.3±0.8)分、住院天数(7.6±3.6)d低于对照组(81.2±21.4)min、(132.3±28.1)ml、(3.2±1.2)分、(13.4±5.4)d,比较差异显著(P<0.05);A组患者住院天数(6.7±2.7)、肛门排气时间(31.3±4.7)、并发症率6.67%均低于B组(8.4±3.5)、(38.6±6.5)、26.67%,术后3d进食率80.0%高于B组53.3%,比较均具有显著差异(P<0.05)。结论腹腔镜胆囊切除术作为临床治疗急性胆囊炎的安全有效疗法,手术时机选择的差异对患者病情康复有较大影响;一般认为急性胆囊炎发病后3d内尽早行腹腔镜胆囊切除术对改善患者术后进食情况,减少住院时间、肛门排气时间和并发症发生风险效果较好,有利于病情早日康复。
Objective To investigate the effect of laparoscopic cholecystectomy with different timing of surgery on the rehabilitation of patients with acute cholecystitis. Methods A total of 84 patients with acute cholecystitis diagnosed from April 2013 to October 2014 were selected and randomized into two groups. Among them, 24 patients were treated with conventional open cholecystectomy as the control group and the other 60 patients The group treated with laparoscopic cholecystectomy was recorded as the observation group, and the therapeutic effect was compared between the two groups. The observation group was further subdivided into A and B2 groups, 30 cases in each group. Surgical treatment was performed in group A within 3d and in group B after 3d Surgical operation was performed to further analyze the effects of different timing of surgery on patient rehabilitation. Results The operation time (62.4 ± 18.7) min, blood loss (74.3 ± 22.4) ml in the observation group and VAS (2.3 ± 0.8) and the length of hospital stay (7.6 ± 3.6) d at 12h after operation were significantly lower than those in the control group (81.2 ± 21.4 ), (132.3 ± 28.1) ml, (3.2 ± 1.2) and (13.4 ± 5.4) d, respectively, with a significant difference between the two groups (P <0.05) ± 4.7). The complication rate was 6.67%, which was lower than that of group B (8.4 ± 3.5), (38.6 ± 6.5) and 26.67% respectively. The rate of postoperative feeding was 80.0%, which was significantly higher than that of group B (53.3% <0.05). Conclusion Laparoscopic cholecystectomy as a safe and effective treatment for clinical treatment of acute cholecystitis, the timing of surgical options for the differences in patient rehabilitation has a greater impact; generally considered acute cholecystitis as early as 3 days after the onset of laparoscopic cholecystectomy to improve patients Postoperative eating, reduce hospital stay, anal exhaust time and complications of the risk effect is better, is conducive to the rapid recovery of the disease.