医学临床研究
醫學臨床研究
의학림상연구
JOURNAL OF CLINICAL RESEARCH
2014年
5期
980-982
,共3页
胆囊炎,急性/并发症%胰腺炎,急性坏死性/并发症%胆囊切除术%胆结石/并发症
膽囊炎,急性/併髮癥%胰腺炎,急性壞死性/併髮癥%膽囊切除術%膽結石/併髮癥
담낭염,급성/병발증%이선염,급성배사성/병발증%담낭절제술%담결석/병발증
Cholecystitis,Acute/CO%Pancreatitis,Acute Necrotizing/CO%Cholecystectomy%Cholelithiasis/CO
【目的】探讨急性结石性胆囊炎（ACC）伴急性胰腺炎（AP）患者行胆囊切除术的手术时机及其临床效果。【方法】2011年1月至2013年12月本院收治的急性结石性胆囊炎伴急性胰腺炎的患者49例，按手术时机不同分为 A、B两组。A组11例患者在入院72 h内行手术治疗（手术时血淀粉酶高于正常水平）；B组38例患者先行非手术治疗，待体温、血淀粉酶基本正常（5～16 d）再行胆囊切除手术。对比两组手术情况及术后临床观察指标。【结果】A组腹腔镜手术率、开腹手术率、中转开腹率分别为81．82％，9．09％，9．09％，B组为92．11％，5．26％，2．63％，两组上述指标差异均无统计学意义（P＞0．05）。两组引流管留置时间无明显差异（P＞0．05）。B组住院时间，血、尿淀粉酶，白细胞恢复时间短于 A组（P＜0．05）。A组、B组并发症发生率比较（9．09％ vs 2．63％）差异无显著性（P＞0．05）。随访半年，49例患者无一例复发。【结论】ACC合并 AP行胆囊切除术治疗预后良好；治疗的首选方法是先行非手术治疗，待患者炎症消退，血、尿淀粉酶恢复正常之后，1再行手术。
【目的】探討急性結石性膽囊炎（ACC）伴急性胰腺炎（AP）患者行膽囊切除術的手術時機及其臨床效果。【方法】2011年1月至2013年12月本院收治的急性結石性膽囊炎伴急性胰腺炎的患者49例，按手術時機不同分為 A、B兩組。A組11例患者在入院72 h內行手術治療（手術時血澱粉酶高于正常水平）；B組38例患者先行非手術治療，待體溫、血澱粉酶基本正常（5～16 d）再行膽囊切除手術。對比兩組手術情況及術後臨床觀察指標。【結果】A組腹腔鏡手術率、開腹手術率、中轉開腹率分彆為81．82％，9．09％，9．09％，B組為92．11％，5．26％，2．63％，兩組上述指標差異均無統計學意義（P＞0．05）。兩組引流管留置時間無明顯差異（P＞0．05）。B組住院時間，血、尿澱粉酶，白細胞恢複時間短于 A組（P＜0．05）。A組、B組併髮癥髮生率比較（9．09％ vs 2．63％）差異無顯著性（P＞0．05）。隨訪半年，49例患者無一例複髮。【結論】ACC閤併 AP行膽囊切除術治療預後良好；治療的首選方法是先行非手術治療，待患者炎癥消退，血、尿澱粉酶恢複正常之後，1再行手術。
【목적】탐토급성결석성담낭염（ACC）반급성이선염（AP）환자행담낭절제술적수술시궤급기림상효과。【방법】2011년1월지2013년12월본원수치적급성결석성담낭염반급성이선염적환자49례，안수술시궤불동분위 A、B량조。A조11례환자재입원72 h내행수술치료（수술시혈정분매고우정상수평）；B조38례환자선행비수술치료，대체온、혈정분매기본정상（5～16 d）재행담낭절제수술。대비량조수술정황급술후림상관찰지표。【결과】A조복강경수술솔、개복수술솔、중전개복솔분별위81．82％，9．09％，9．09％，B조위92．11％，5．26％，2．63％，량조상술지표차이균무통계학의의（P＞0．05）。량조인류관류치시간무명현차이（P＞0．05）。B조주원시간，혈、뇨정분매，백세포회복시간단우 A조（P＜0．05）。A조、B조병발증발생솔비교（9．09％ vs 2．63％）차이무현저성（P＞0．05）。수방반년，49례환자무일례복발。【결론】ACC합병 AP행담낭절제술치료예후량호；치료적수선방법시선행비수술치료，대환자염증소퇴，혈、뇨정분매회복정상지후，1재행수술。
[Objective]To explore the operation time and clinical efficacy of cholecystectomy for patients of acute calculous cholecystitis(ACC)accompanied by acute pancreatitis(AP).[Methods]According to the opera-tion time,49 ACC patients with AP in our hospital from Jan.2011 to Dec.2013 were divided into group A and group B.Group A(n=11)underwent surgical treatment within 72 hours at admission(blood amylase still higher than normal level during the operation).Group B(n=38)received non-surgical treatment in advance, and then underwent the operation until body temperature and blood amylase returned to normal level(5~16d). The operation condition and clinical indexes were compared between two groups.[Results]Laparoscopy rate, laparotomy rate and conversion rate of laparotomy in group A were 81.82%,9.09% and 9.09% respectively, and those in group B were 92.11%,5.26% and 2.63% respectively,but there was no significant difference between two groups(P>0.05).There was no significant difference in the time of placing drainage tube be-tween two groups(P>0.05).Hospital stay and the time of blood amylase,urine amylase and white blood cell returning to normal in group B were shorter than those in group A(P <0.05).There was no significant difference in the incidence of complications between two groups(9.09% vs.2.63%,P>0.05).All patients were followed up for 6 months.No recurrence was found in 49 patients.[Conclusion]Cholecystectomy for ACC complicated with AP has good prognosis.The first choice of treatment is non-surgical treatment in ad-vance and then the operation until body temperature and blood amylase return to normal level.
