Management skills for emergency laparoscopic cholecystectomy in treating acute cholecystitis
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摘要:目的 探讨急性胆囊炎行急诊腹腔镜胆囊切除术的处理技巧。方法 选取32例急性胆囊炎患者随机分为对照组和观察组，各16例，对照组患者采用常规开腹手术治疗，观察组患者采用腹腔镜手术治疗，分析并比较2组患者的治疗效果。结果 观察组的治疗总有效率为93.75%, 显著高于对照组的62.50%(P < 0.05); 观察组的术中出血量、手术时间、住院时间均显著优于对照组(P < 0.05)。结论 采用急诊腹腔镜胆囊切除术治疗急性胆囊炎患者的有效性和安全性均比较高。急性胆囊炎患者实施急诊腹腔镜胆囊切除术时，必须合理选择手术治疗时机，且手术操作人员必须掌握急诊腹腔镜胆囊切除术的操作技巧。
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关键词:
- 急性胆囊炎 /
- 急诊腹腔镜胆囊切除术 /
- 处理技巧 /
- 术中出血量 /
- 手术时间
Abstract:Objective To explore management skills for emergency laparoscopic cholecystectomy in treating acute cholecystitis.Methods A total of 32 patients with acute cholecystitis admitted to our hospital were randomly divided into control group and observation group, with 16 cases in each group. The patients in control group were given routine laparotomy, and those in observation group were given laparoscopic surgery. The therapeutic effects of the two groups were compared and analyzed.Results Compared with the control group, the total effective rate in the observation group was higher than that in the control group (93.75% vs. 62.50%, P < 0.05). The bleeding volume, operation time and hospitalization time in the observation group were better than those in the control group (P < 0.05).Conclusion Emergency laparoscopic cholecystectomy has higher safety and efficacy. And the timing of operation must be reasonably selected for the patients with acute cholecystitis who underwent the surgery, and the operators must master the operation skills of emergency laparoscopic cholecystectomy. -
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表 1 2组患者手术相关指标比较(x±s)
组别 n 术中出血量/mL 手术时间/min 住院时间/d 对照组 16 135.27±17.94 165.66±23.42 14.23±2.21 观察组 16 71.34±10.69* 121.36±17.51* 5.31±1.64* 与对照组比较, *P < 0.05。 
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[1] Kim I G, Kim J S, Jeon J Y, et al. Percutaneous transhepatic gallbladder drainage changes emergency laparoscopic cholecystectomy to an elective operation in patients with acute cholecystitis[J]. J Laparoendosc Adv Surg Tech A, 2011, 21(10): 941-946. doi: 10.1089/lap.2011.0217
[2] 周志林, 梅勇, 杨旭辉, 等. 经皮经肝胆囊穿刺引流术联合延期胆囊切除术治疗急性胆囊炎患者近期疗效研究[J]. 实用肝脏病杂志, 2019, 22(4): 597-600. doi: 10.3969/j.issn.1672-5069.2019.04.037 [3] 解方哲, 郑春生, 陈坤鹏. 腹腔镜胆囊切除术与开放性胆囊切除术治疗急性胆囊炎的效果对比[J]. 当代医药论丛, 2019, 17(12): 17-19. doi: 10.3969/j.issn.2095-7629.2019.12.011 [4] 韩明义. 冲吸钝性解剖法在对急性胆囊炎患者进行腹腔镜胆囊切除术中的应用效果[J]. 当代医药论丛, 2018, 16(22): 54-55. doi: 10.3969/j.issn.2095-7629.2018.22.040 [5] 徐旻. 腹腔镜胆囊切除术与传统胆囊切除术在急性胆囊炎患者中的应用价值对比研究[J]. 心血管外科杂志: 电子版, 2018, 7(4): 669-670. doi: 10.3969/j.issn.2095-2260.2018.04.038 [6] 涂月英, 谢丽鹏. 基于循证理念的疼痛护理对腹腔镜胆囊切除术患者疼痛程度和生活质量的影响[J]. 基层医学论坛, 2019, 23(24): 3438-3439. https://www.cnki.com.cn/Article/CJFDTOTAL-YXLT201924018.htm [7] 郑育秀. 全身麻醉联合硬膜外麻醉对老年高血压腹腔镜胆囊切除术患者心率变异性及应激水平的影响[J]. 中国老年学杂志, 2019, 39(15): 3678-3680. doi: 10.3969/j.issn.1005-9202.2019.15.025 [8] 冯建超. 经皮经肝胆囊穿刺引流术联合腹腔镜胆囊切除术治疗急性胆囊炎的疗效观察[J]. 现代诊断与治疗, 2018, 29(23): 3855-3856. doi: 10.3969/j.issn.1001-8174.2018.23.044 [9] 张明. 腹腔镜胆囊切除术与开腹胆囊切除术治疗老年急性胆囊炎的疗效比较[J]. 当代医学, 2019, 25(3): 158-159. doi: 10.3969/j.issn.1009-4393.2019.03.071 [10] Karakayali F Y, Akdur A, Kirnap M, et al. Emergency cholecystectomy vs percutaneous cholecystostomy plus delayed cholecystectomy for patients with acute cholecystitis[J]. HBPD INT, 2014, 13(3): 316-322.
[11] Ferrarese A, Martino V, Nano M. Elective and emergency laparoscopic cholecystectomy in the elderly: early or delayed approach[J]. BMC Geriatr, 2011, 11(1): A14-A14. doi: 10.1186/1471-2318-11-14
[12] Suter M, Meyer A. A 10-year experience with the use of laparoscopic cholecystectomy for acute cholecystitis: is it safe[J]. Surg Endosc, 2001, 15(10): 1187-1192. doi: 10.1007/s004640090098
[13] 吴国富. 老年急性胆囊炎行腹腔镜胆囊切除术与开腹胆囊切除术的临床疗效差异分析[J]. 名医, 2019(5): 112-112. https://www.cnki.com.cn/Article/CJFDTOTAL-MGYI201905106.htm [14] 阿卜来提·穆太力普, 米娜瓦尔·麦麦提, 布合丽且姆·多来提. 腹腔镜胆囊切除术治疗急性胆囊炎并发胆结石的安全性及预后分析[J]. 临床医药文献电子杂志, 2019, 6(3): 32-33. doi: 10.3877/j.issn.2095-8242.2019.03.022 [15] 刘奇, 李世蒙, 张玉勤, 等. 小半夏汤加味贴剂"一贴轻"对腹腔镜胆囊切除术后恶心呕吐及血浆5-HT的影响[J]. 现代中西医结合杂志, 2019, 28(22): 2404-2407. doi: 10.3969/j.issn.1008-8849.2019.22.003 -
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