腹腔镜和开腹手术治疗结石性胆囊炎疗效探讨

目的：观察腹腔镜和开腹手术治疗结石性胆囊炎的临床疗效，探讨术后并发症的发生率、患者的康复情况并评价手术的安全性。方法：选取2012年2月．2013年4月我院肝胆外科住院治疗的急性结石性胆囊炎患者100倒，随机分为观察组和对照组，每组50例。观察组采用腹腔镜手术治疗；对照组采用传统开腹手术治疗。观察并比较两组的手术时间、术中出血量、愈合时间、术后并发症及患者恢复情况等。结果：观察组手术治疗的有效率为96％，对照组为80％，差异具有统计学意义（P〈0．05）；观察组术后出现胆心反射3例，腹腔出血l例，感染2例；对照组术后出现胆心反射3例，腹腔出血4例，感染5例，差异有统计学意义（P〈0．05）。结论：腹腔镜治疗结石性胆囊炎较传统开腹手术治疗术式疗效显著，术中出血较少，并发症少，术后恢复快，患者术后痛苦少，值得临床推广。

Comparison of the Clinical Efficacy between Laparoscopic and Open Surgery on the Treatment of Cholecystitis

Objective： To observe the clinical effect oflaparoscopic and open operation in the treatment of calculous cholecystitis, and to compare the postoperative complications, rehabilitation and to evaluate the operation safety. Method~ 100 cases with acute eholecystitis who were treated in our hospital from February 2012 to April 2013 were selected to take part in the research and randomly divided into the observation group and the control group, 50 cases in each group. Patients in the observation group were treated by laparoscopic, while patients in the control group were treated by the conventional open surgery. Then the operation time, blood loss, the healing time, the incidence of complications and postoperative recovery of patients were observed and compared between two groups. Results： The effective rate of the observation group was 96% which in the control group was 80%, and there was statistically significant difference between two groups （p〈0.05）; In the observation group, three cases represented the postoperative bile cardiac reflex, one cases showed the abdominal hemorrhage and two case were infectious; in the control group, three cases represented the postoperative bile cardiac reflex, four cases showed the abdominal hemorrhage and five cases were infectious, and there was statistically significant difference between two groups （p〈0.05）. Conclusion： The treatment of calculous cholecystitis laparoscopic is worthy of clinical application significantly when compared with traditional open operation treatment with the advantages of high clinical efficacy, less blood loss, fewer incidence of complications, faster postoperative recovery, less postoperative pain of patients.