腹腔镜胆囊切除术与开腹手术在老年急性胆囊炎患者中的应用比较

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　　[摘要]目的 比較分析腹腔镜胆囊切除术与开腹手术对老年急性胆囊炎患者住院时间及并发症的影响。方法 选取2017年7月～2019年6月我院收治的58例老年急性胆囊炎患者作为研究对象，按照随机数字表法将其分为观察组（40例）和对照组（18例）。观察组患者采用腹腔镜胆囊切除术方法治疗，对照组患者采用开腹手术方法治疗。比较两组患者手术前后的炎症因子水平、术后手术相关指标、并发症发生情况。结果 术后，观察组患者的C反应蛋白（CRP）水平低于对照组，差异有统计学意义（P<0.05）;观察组患者的胃肠功能恢复时间、住院时间、手术时间、术后肠鸣音恢复时间短于对照组，差异有统计学意义（P<0.05）;观察组患者的术后并发症总发生率低于对照组，差异有统计学意义（P<0.05）。结论 与传统开腹手术治疗方法相比，腹腔镜胆囊切除术可有效降低患者的炎症因子水平，缩短其术后康复时间，减少并发症情况的发生，提高治疗效果。
　　[关键词]老年急性胆囊炎;腹腔镜胆囊切除术;开腹手术;炎症因子;安全性
　　[中图分类号] R657.4          [文献标识码] A          [文章编号] 1674-4721（2020）5（c）-0090-04
　　Application comparison of laparoscopic cholecystectomy and open surgery in senile patients with acute cholecystitis
　　FANG Chang-wen   LAN Jiang   ZHAN Wei-lin
　　Department of General Surgery， Guixi People′s Hospital， Jiangxi Province， Guixi   335400， China
　　[Abstract] Objective To compare and analysis the effect of laparoscopic cholecystectomy and open surgery on the length of stay and complications in senile patients with acute cholecystitis. Methods A total of 58 senile patients with acute cholecystitis who were treated in our hospital from July 2017 to June 2019 were divided into observation group （n=40） and control group （n=18） according to random number table method. Observation group was treated with laparoscopic cholecystectomy， and control group was treated with open surgery. The inflammatory factors before and after surgery， postoperative surgical indexes and complications were compared between two groups. Results After surgery， the level of C-reactive protein （CRP） in observation group was lower than that in the control group， the difference was statistically significant （P<0.05）. The recovery time of gastrointestinal function， hospital stays， operation time， postoperative recovery time of bowel sound in observation group were shorter than those in control group， with statistically significant differences （P<0.05）. The total incidence of postoperative complications in observation group was lower than that in control group， the difference was statistically significant （P<0.05）. Conclusion Compared with conventional open surgery， laparoscopic cholecystectomy can decrease the levels of inflammatory factors， shorten postoperative recovery time， reduce complications， and improve curative effects.
　　[Key words] Senile patients with acute cholecystitis; Laparoscopic cholecystectomy; Open surgery; Inflammatory factors; Safety
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