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目的 :探讨不同时间点的腹腔镜手术对急性结石性胆囊炎预后的影响。方法 :将135例急性结石性胆囊炎患者按照发病时间的不同分为三组,A组(48h内)有52例,B组(48h~72h)有45例,C组(72h以后)有38例;全部患者均采用腹腔镜胆囊切除术治疗。对比三组手术基本情况、术后恢复情况及并发症发生情况。结果 :A组手术时间、中转开腹率与B组对比差异无统计学意义;B组术中出血量显著高于A组;C组手术时间、术中出血量、中转开腹率均显著高于A组与B组;A组术后首次排气时间、肠鸣音恢复时间、术后住院时间与B组对比差异无统计学意义;C组术后首次排气时间、肠鸣音恢复时间、术后住院时间均显著高于A组与B组;A组与B组间并发症发生率对比差异无统计学意义;C组并发症发生率显著高于A组与B组,差异有统计学意义。结论 :急性结石性胆囊炎患者在发病72h内进行腹腔镜胆囊切除术,具有手术时间短、创伤小、恢复快、并发症少等特点;发病72h后仍可选择性进行腹腔镜手术。
Objective: To investigate the effect of laparoscopic surgery at different time points on the prognosis of acute calculous cholecystitis. Methods: One hundred and fifty-five patients with acute calcific cholecystitis were divided into three groups according to the time of onset. There were 52 cases in group A (48 hours), 45 cases in group B (48 hours-72 hours) and 38 cases in group C Cases; all patients were treated with laparoscopic cholecystectomy. Comparing the basic situation of the three groups of surgery, postoperative recovery and complications. Results: There was no significant difference between the two groups in the operation time and the rate of laparotomy in group A. The bleeding volume in group B was significantly higher than that in group A. The operation time, intraoperative blood loss and transfer to laparotomy in group C were significantly higher In group A and group B, there was no significant difference between group A and group B. There was no significant difference between group A and group B. In group C, the first time of exhaust, the time of recovery of bowel sounds, , Postoperative hospital stay were significantly higher than those in group A and group B. There was no significant difference in the incidence of complications between group A and group B. The incidence of complications in group C was significantly higher than that in group A and group B Significance of learning. Conclusions: Laparoscopic cholecystectomy is performed within 72 hours of onset in patients with ACCP. It has the advantages of shorter operation time, less trauma, faster recovery and fewer complications. Laparoscopic surgery is still optional after 72 hours.