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目的:分析新疆和田地区急性胆囊炎患者从发病到行腹腔镜胆囊切除术手术的时间,分析出现并发症的情况,并找出最优手术时间。方法:回顾性分析研究在我院2009年1月~2014年12月期间手术的急性胆囊炎患者288例的临床资料,将发病到行手术的时间分为三组,A组(0~1天),B组(2~5天),C组(6~10天)。结果:B组中转开腹、切口感染率均高于A和C组(P<0.05);C组在胆道损伤、术后住院时间和死亡率均高于A组和B组(P<0.05);C组的术后住院时间明显长于A组和B组(P<0.05),经研究分析发现,急性胆囊炎患者最优手术时间为48h以内。结论:急性胆囊炎患者在2天内行腹腔镜胆囊切除术,其术后效果最好,住院花费最低。虽然没有找出确凿的因果关系,但延迟手术时间明显的增加了患者死亡率、并发症以及患者的住院成本。
OBJECTIVE: To analyze the time from onset to laparoscopic cholecystectomy in patients with acute cholecystitis in Hetian, Xinjiang, analyze the complications and find out the optimal operation time. Methods: The clinical data of 288 patients with acute cholecystitis undergoing surgery in our hospital from January 2009 to December 2014 were retrospectively analyzed. The time from onset to surgery was divided into three groups. Group A (0 to 1 day ), Group B (2 ~ 5 days), group C (6 ~ 10 days). Results: In group B, laparotomy and incision infection rates were higher than those in groups A and C (P <0.05). Ciliary tract injury, postoperative hospital stay and mortality in group C were significantly higher than those in groups A and B (P <0.05) ; The postoperative hospital stay in group C was significantly longer than that in group A and group B (P <0.05). The study found that the optimal operation time for patients with acute cholecystitis was within 48 hours. Conclusions: Laparoscopic cholecystectomy is performed in patients with acute cholecystitis within 2 days, which is the best after surgery and the lowest hospitalization cost. Although no conclusive causal link was found, delayed surgery significantly increased patient mortality, complications, and patient hospitalization costs.