本文選題：胰腺炎 + 腹腔鏡膽囊切除術(shù)��； 參考：《重慶醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：評(píng)估輕型急性膽源性胰腺炎（MABP）患者一期（首次住院期間）行腹腔鏡膽囊切除術(shù)（LC）的可行性以及與延期LC進(jìn)行臨床比較研究。 方法：收集2006年1月至2012年6月我院肝膽外科收治的病人，將符合MABP診斷且一期（首次住院期間）行LC治療的患者納入研究組，共36例；將既往有MABP病史（一次或幾次）已好轉(zhuǎn)出院，延期（緩解后2-6月，無(wú)胰腺炎及膽囊炎發(fā)作）行LC治療的患者納入對(duì)照組，共24例。觀察并記錄兩組病例的一般資料、臨床表現(xiàn)、輔助檢查、治療情況及出院后隨訪等情況，對(duì)組間手術(shù)時(shí)間、總住院時(shí)間及總住院費(fèi)用運(yùn)用統(tǒng)計(jì)學(xué)方法分析。 結(jié)果：全組病例均行LC。研究組與對(duì)照組比較發(fā)現(xiàn)在手術(shù)時(shí)間方面差異無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）；而總住院時(shí)間[研究組為（11.83±3.97）天，對(duì)照組為（31.67±5.03）天]和總住院費(fèi)用[研究組為（23324±5393.60）元，對(duì)照組為（40324±7816.20）元]兩者差異均存在統(tǒng)計(jì)學(xué)意義（P 0.05）。兩組病例術(shù)后隨訪6-12月，研究組及對(duì)照組均無(wú)患者出現(xiàn)胰腺炎復(fù)發(fā)。 結(jié)論：MABP患者住院一期經(jīng)禁食禁飲，胃腸減壓，，使用抗生素及生長(zhǎng)激素抑制素，靜脈補(bǔ)液等對(duì)癥支持治療，臨床癥狀緩解，血清淀粉酶（AMS）、脂肪酶（LPS）基本正常后行LC是安全可行的，并且可降低以后膽源性胰腺炎的復(fù)發(fā)率，減少住院費(fèi)用及住院時(shí)間，減輕患者負(fù)擔(dān)。
[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 鹵3.97 days in the study group and 31.67 鹵5.03 days in the control group, and the total hospitalization cost in the study group was 23324 鹵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.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R657.51

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