轻型急性胆源性胰腺炎一期与延期行腹腔镜胆囊切除术的临床研究

发布时间：2018-04-30 20:14

本文选题：胰腺炎 + 腹腔镜胆囊切除术　；参考：《重庆医科大学》2013年硕士论文

【摘要】：目的：评估轻型急性胆源性胰腺炎（MABP）患者一期（首次住院期间）行腹腔镜胆囊切除术（LC）的可行性以及与延期LC进行临床比较研究。方法：收集2006年1月至2012年6月我院肝胆外科收治的病人，将符合MABP诊断且一期（首次住院期间）行LC治疗的患者纳入研究组，共36例；将既往有MABP病史（一次或几次）已好转出院，延期（缓解后2-6月，无胰腺炎及胆囊炎发作）行LC治疗的患者纳入对照组，共24例。观察并记录两组病例的一般资料、临床表现、辅助检查、治疗情况及出院后随访等情况，对组间手术时间、总住院时间及总住院费用运用统计学方法分析。结果：全组病例均行LC。研究组与对照组比较发现在手术时间方面差异无统计学意义（P0.05）；而总住院时间[研究组为（11.83±3.97）天，对照组为（31.67±5.03）天]和总住院费用[研究组为（23324±5393.60）元，对照组为（40324±7816.20）元]两者差异均存在统计学意义（P 0.05）。两组病例术后随访6-12月，研究组及对照组均无患者出现胰腺炎复发。结论：MABP患者住院一期经禁食禁饮，胃肠减压，，使用抗生素及生长激素抑制素，静脉补液等对症支持治疗，临床症状缓解，血清淀粉酶（AMS）、脂肪酶（LPS）基本正常后行LC是安全可行的，并且可降低以后胆源性胰腺炎的复发率，减少住院费用及住院时间，减轻患者负担。
[Abstract]:Objective: to evaluate the feasibility of laparoscopic cholecystectomy (LC) in patients with mild acute biliary pancreatitis (MABP) and to compare it with delayed LC. Methods: from January 2006 to June 2012, 36 patients who met the diagnosis of MABP and received LC during the first hospitalization were included in the study group. Twenty-four patients with previous history of MABP (once or several times) who had been discharged from hospital and were delayed (2 to 6 months after remission without pancreatitis or cholecystitis) were included in the control group. The general data, clinical manifestation, auxiliary examination, treatment and follow-up after discharge were observed and recorded. The intergroup operation time, total hospitalization time and total hospitalization cost were analyzed by statistical method. Results: all cases were treated with LC. There was no significant difference in operation time between the study group and the control group, but the total hospital stay was 11.83 卤3.97 days in the study group and 31.67 卤5.03 days in the control group, and the total hospitalization cost in the study group was 23324 卤5393.60 yuan. The difference between the two groups was statistically significant (P 0.05). Patients in both groups were followed up for 6-12 months. No recurrence of pancreatitis was found in the study group and the control group. Conclusion it is safe and feasible to take LC after fasting, gastrointestinal decompression, antibiotics and growth hormone inhibin, intravenous fluid resuscitation, clinical symptom relief, serum amylase AMSN and lipase LPSs. It can reduce the recurrence rate of biliary pancreatitis, reduce the hospitalization cost and hospitalization time, and lighten the burden of the patients.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R657.51

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