腹腔镜下胆囊切除术治疗胆囊疾病的应用效果观察(1)
【摘要】目的 观察腹腔镜下胆囊切除术治疗胆囊疾病的临床应用效果。方法 选择我院外科收治的拟行手术治疗的胆囊疾病患者80例，随机分为腹腔镜组(F组，40例)和开腹组(K组，40例)。F组患者行腹腔镜下胆囊切除术，K组患者行传统开腹术。观察两组患者的疗效指标情况。结果 F组患者平均手术治疗时间、术中平均出血量、平均住院天数均显著少于K组，术后下床活动时间和肠道恢复时间明显早于K组，差异有统计学意义(P<0.05)。结论 腹腔镜下胆囊切除术具有手术时间短、术中出血量少、平均住院时间短、早期即能下床活动以及肠道功能恢复快等优点，可作为首选手术方式。
【关键词】腹腔镜；胆囊切除；胆囊疾病
【中圖分类号】R616.2 【文献标识码】B 【文章编号】ISSN.2095-6681.2016.36..02
Observation on the effect of laparoscopic cholecystectomy in the treatment of gallbladder diseases
CAI Ai-min
(The third people's Hospital of Jiangsu city of Taixing Province，Jiangsu Taixing 225400，China)
【Abstract】Objective To observe the clinical effect of laparoscopic cholecystectomy in the treatment of gallbladder diseases. Methods Eighty patients with gallbladder diseases who were treated surgically in our hospital were randomly divided into the laparoscopic group (group F， 40 cases) and laparotomy group (group K，40 cases).Laparoscopic cholecystectomy was performed in group F， and conventional laparotomy was performed in group K.The clinical efficacy indicators of the two groups were observed.Results Patients in group F with the average surgery time， average intraoperative bleeding volume， average hospitalization days were significantly less than group K， postoperative ambulation time， postoperative intestinal recovery time was significantly earlier than that in group K， the differences were statistically significant (P<0.05).Conclusion Laparoscopic cholecystectomy has the advantages of shorter operation time， less blood loss， shorter average hospitalization time， early ambulation and quick recovery of intestinal function. It can be used as the first choice of operation.
【Key Words】Laparoscopy；Cholecystectomy；Gallbladder diseases
胆囊疾病是常见的外科疾病之一，多数需要实施胆囊切除手术治疗，常用的手术方式为开腹胆囊切除术和腹腔镜下胆囊切除术，两种方式各有利弊，互为利用[1]。我院外科手术组通过对需要手术治疗的胆囊疾病患者进行腹腔镜下胆囊切除术和开腹胆囊切除术的效果的比较，观察两组患者的疗效指标情况。现报告如下。
1 资料与方法
1.1 一般资料
选择我院外科收治的拟行胆囊切除术的胆囊疾病患者80例，其中：男46例，女34例；年龄26～65岁，平均(45.23±1.51)岁；胆囊结石70例，胆囊息肉6例，急性胆囊结石伴胆囊炎4例。随机分为腹腔镜组(F组，40例)和开腹组(K组，40例)。F组男22例，女18例；年龄26～64岁，年龄(45.15±1.45)岁；胆囊结石34例，胆囊息肉4例，急性胆囊结石伴胆囊炎2例。K组男24例，女16例；年龄27～65岁，年龄(45.25±1.55)岁；胆囊结石36例，胆囊息肉2例，急性胆囊结石伴胆囊炎2例。两组患者的一般资料相比较，差异无统计学意义(P>0.05)。
1.2 手术方法
两组患者均在气管插管全身麻醉下实施手术。
1.2.1 F组患者行腹腔镜下胆囊切除术
患者先取平卧位，麻醉成功后建立人工气腹，改体位为头高脚低位，向左侧稍倾斜，视手术情况再制造两至三个穿刺孔，植入内镜器械，暴露出胆囊三角等重要的手术部位，搞清胆囊动脉和胆囊管的解剖关系并牢固夹闭，切除胆囊，再缝合其孔道，视需要决定是否留置腹腔引流管。
1.2.2 K组患者行传统的开腹胆囊切除术
患者取平卧位，麻醉成功后常规消毒，选择右上腹腹直肌或者肋缘下长约8～10 cm的切口，按常规步骤进行胆囊切除术，腹腔内存在严重感染时可放置引流管。, http://www.100md.com(蔡爱民)
【关键词】腹腔镜；胆囊切除；胆囊疾病
【中圖分类号】R616.2 【文献标识码】B 【文章编号】ISSN.2095-6681.2016.36..02
Observation on the effect of laparoscopic cholecystectomy in the treatment of gallbladder diseases
CAI Ai-min
(The third people's Hospital of Jiangsu city of Taixing Province，Jiangsu Taixing 225400，China)
【Abstract】Objective To observe the clinical effect of laparoscopic cholecystectomy in the treatment of gallbladder diseases. Methods Eighty patients with gallbladder diseases who were treated surgically in our hospital were randomly divided into the laparoscopic group (group F， 40 cases) and laparotomy group (group K，40 cases).Laparoscopic cholecystectomy was performed in group F， and conventional laparotomy was performed in group K.The clinical efficacy indicators of the two groups were observed.Results Patients in group F with the average surgery time， average intraoperative bleeding volume， average hospitalization days were significantly less than group K， postoperative ambulation time， postoperative intestinal recovery time was significantly earlier than that in group K， the differences were statistically significant (P<0.05).Conclusion Laparoscopic cholecystectomy has the advantages of shorter operation time， less blood loss， shorter average hospitalization time， early ambulation and quick recovery of intestinal function. It can be used as the first choice of operation.
【Key Words】Laparoscopy；Cholecystectomy；Gallbladder diseases
胆囊疾病是常见的外科疾病之一，多数需要实施胆囊切除手术治疗，常用的手术方式为开腹胆囊切除术和腹腔镜下胆囊切除术，两种方式各有利弊，互为利用[1]。我院外科手术组通过对需要手术治疗的胆囊疾病患者进行腹腔镜下胆囊切除术和开腹胆囊切除术的效果的比较，观察两组患者的疗效指标情况。现报告如下。
1 资料与方法
1.1 一般资料
选择我院外科收治的拟行胆囊切除术的胆囊疾病患者80例，其中：男46例，女34例；年龄26～65岁，平均(45.23±1.51)岁；胆囊结石70例，胆囊息肉6例，急性胆囊结石伴胆囊炎4例。随机分为腹腔镜组(F组，40例)和开腹组(K组，40例)。F组男22例，女18例；年龄26～64岁，年龄(45.15±1.45)岁；胆囊结石34例，胆囊息肉4例，急性胆囊结石伴胆囊炎2例。K组男24例，女16例；年龄27～65岁，年龄(45.25±1.55)岁；胆囊结石36例，胆囊息肉2例，急性胆囊结石伴胆囊炎2例。两组患者的一般资料相比较，差异无统计学意义(P>0.05)。
1.2 手术方法
两组患者均在气管插管全身麻醉下实施手术。
1.2.1 F组患者行腹腔镜下胆囊切除术
患者先取平卧位，麻醉成功后建立人工气腹，改体位为头高脚低位，向左侧稍倾斜，视手术情况再制造两至三个穿刺孔，植入内镜器械，暴露出胆囊三角等重要的手术部位，搞清胆囊动脉和胆囊管的解剖关系并牢固夹闭，切除胆囊，再缝合其孔道，视需要决定是否留置腹腔引流管。
1.2.2 K组患者行传统的开腹胆囊切除术
患者取平卧位，麻醉成功后常规消毒，选择右上腹腹直肌或者肋缘下长约8～10 cm的切口，按常规步骤进行胆囊切除术，腹腔内存在严重感染时可放置引流管。, http://www.100md.com(蔡爱民)