摘要
目的探讨腹腔镜胆囊切除手术(laparoscopic cholecystectomy,LC)与小切口胆囊切除手术(minilaparotomy cholecystectomy,MC)治疗胆囊结石合并胆囊炎的疗效及应用价值,为临床治疗提供相应依据.方法收集2010年2月至2014年1月在郧西县人民医院收治的83例胆囊结石合并胆囊炎患者作为研究对象,按照治疗方式不同分为MC组39例和LC组44例.MC组患者给予MC手术治疗;LC组患者给予LC手术治疗.比较2组患者手术状况、术后恢复状况、并发症发生率、复发率及术后患者生存质量.结果 MC组39例与LC组44例均顺利完成胆囊切除手术.MC组切口长度显著长于LC组,术中出血量显著多于LC组,手术时间显著长于LC组,P<0.05,差异均具有统计学意义.LC组禁食时间、抗菌治疗时间、下床时间及住院时间均显著短于MC组,医疗费用显著高于MC组,差异均具有统计学意义(P<0.05).2组患者胆管损伤、胆汁瘘、术后腹泻及切口感染发生率均无显著统计学差异(P>0.05),但是MC组患者并发症总发生率为23.1%,显著高于LC组患者2.3%,差异具有统计学意义(P<0.05).2组患者12个月内均无复发病例.LC组患者生存质量指数评分高达(119.6±12.7)分,显著高于MC组患者(107.9±14.4)分,差异具有统计学意义(P<0.05).结论 LC手术治疗胆囊结石合并胆囊炎尽管手术费用相对较高,但是疗效显著,术后恢复快、并发症发生率低,并显著提高患者生存质量,值得在临床上进一步深入探讨研究与推广应用.
Objective To compare the clinical efficacy between laparoscopic cholecystectomy （LC） and minilaparotomy eholecysteetomy （MC） in treating gallstone complicating eholecystitis （GCC） and provide the clinical basis. Methods From February 2010 to January 2014, 83 GCC cases were collected in our hospital and were divided into two groups by treatments, including 39 cases in MC group and 44 cases in LC group. The cases in MC group were treated with MC surgery and the LC group cases were treated with LC surgery. The indexes of surgery, postoperative recovery, complication rate, recurrence rate, and the gastrointestinal quality of life indexes （GQLI） were observed and compared. Results Both two groups were received successful surgery. Compared with the LC group, the MC group bad significantly longer incision, more bleeding and longer time ofsurgery （P 〈0.05） . Compared with the MC group, the LC group had significantly shorter fasting time, antibacterial treatment time, action time, and hospitalization time, but significantly more expenses （P〈0.05） There were no significant differences in the complication rates including bile duct injury, bile fistula, post-operation diarrhea and incision infection between the two groups （P〉0.05） . The total complication rate of LC was 2.3%, which was significantly lower than that of the MC group （23.1%） （P〈0.05） . The GQLI of the LC group was 119.6 ＋ 12.7） point, which was significantly higher than that of the MC group （P 〈0.05） Conclusion Although LC surgery is relatively expensive, it has efficient efficacy, quick recovery, lower complication rate and higher life quality for GCC patents, which was worthy of further application in clinical therapy. This study might providea new evidence for CCGP treatment.
出处
《昆明医科大学学报》
CAS
2015年第12期37-40,共4页
Journal of Kunming Medical University
基金
浙江省自然科学基金资助项目(LQ13H100112)
关键词
腹腔镜
小切口
胆囊切除手术
胆囊结石
胆囊炎
Laparoscopic cholecystectomy
Minilaparotomy cholecystectomy
Gallstone
Cholecystitis
