摘要
目的探析腹腔镜下胆囊切除术治疗急性胆囊炎的最佳时机及影响中转开腹的因素。方法便利选取该院2014年6月—2016年12月期间收治的86例急性胆囊炎患者,根据发病至手术时间不同进行分组,I组30例48 h内、II组30例48~72 h、III组26例72 h以上,比较3组手术时间、并发症、中转开腹影响因素。结果 I组手术时间(39.5±10.4)min、II组(48.6±8.4)min、III组(60.7±16.3)min,差异有统计学意义(P<0.05);I组中转开腹率0.00%、II组13.33%、III组23.08%,差异有统计学意义(P<0.05)。经Logistic分析,白细胞计数(OR=3.211)、胆囊颈部结石嵌顿(OR=2.498)以及手术时机(OR=2.845)是导致术中中转开腹的独立危险因素。结论急性胆囊炎应尽早手术,其最佳时机为发病48 h内,可减少手术耗时,降低中转开腹率。
Objective To study the best opportunity of laparoscopic cholecystotomy in treatment of acute cholecystitis and influence factors of conversion to open laparotomy. Methods 86 cases of patients with acute cholecystitis admitted and treated in our hospital from June 2014 to December 2016 were conveniently selected and divided into two groups according to time from onset to operation, and the group I(n=30) was in 48 h, the group II(n=30) was between 48 h to 72 h and the group III(n=26) was above 72 h,and the influence factors of operation time, complications and conversion to open laparotomy were compared between the three groups. Results The difference in the operation time between the three groups had statistical significance, [(39.5±10.4),(48.6±8.4),(60.7±16.3)min](P<0.05), and the difference in the conversion to open laparotomy between the three groups had statistical significance,(0.00%, 13.33%, 23.08%)(P<0.05), and the Logistic analysis showed that the white cell count(OR=3.211), stone incarceration in neck of gallbladder(OR=2.498)and operation opportunity(OR=2.845) were the independent risk factors of intraoperative conversion to open laparotomy. Conclusion We should conduct operation for acute cholecystitis as soon as possible and the best opportunity is in 48 h after the attack,which can reduce the operation time and reduce the rate of conversion to open laparotomy.
出处
《中外医疗》
2017年第6期67-69,共3页
China & Foreign Medical Treatment
关键词
腹腔镜
急性胆囊炎
最佳时机
中转开腹
Laparoscopy
Acute cholecystitis
Best opportunity
Conversion to open laparotomy
