ABSTRACT
Objective To explore the impact of open and laparoscopic cholecystectomy of different operation methods on postoperative intestinal adhesions.Methods 128 patients with acute cholecystitis were randomly divided into the observation group (64 cases)and control group (64 cases).The control group was treated with open chole-cystectomy,the observation group was treated with laparoscopic cholecystectomy.The postoperative intestinal function, complications and intestinal adhesion were compared between the two groups.Results The bleeding amount,incision size,operation time of the observation group were (132.29 ±27.28)mL,(3.9 ±0.2)cm,(102.1 ±20.9)min,which were significantly better than those of the control group [(197.44 ±31.21 )mL,(15.4 ±2.3 )cm,(129.5 ± 30.6)min],the differences were statistically significant(t =12.574,38.850,5.915,P <0.05).The incision healing time,bowel sounds recovery time,exhaust time of the observation group were (8.65 ±0.75)h,(23.63 ±5.14)h, (31.65 ±10.71)h,which were significantly shorter than those of the control group [(13.27 ±1.18)h,(36.17 ± 7.14)h,(46.35 ±13.36)h],the differences were statistically significant (t =26.434,11.403,6.868,all P <0.05).The length of hospital stay and hospitalization expenses of the observation group were (3.9 ±1.6)d,(9 830 ± 840)RMB,which were significantly less than those of the control group [(5.7 ±2.4)d,(1 2876 ±703)RMB](t =4.992,22.247,all P <0.05).Conclusion Laparoscopic cholecystectomy can not only reduce intraoperative bleed-ing volume and operation time,promote postoperative intestinal function recovery,but also can save the cost of hospi-talization,reduce complications and the incidence of intestinal viscosity.Security is good,it is recommended.
ABSTRACT
Recurrent laryngeal nerve injury is one of the serious complications after thyroidectomy.Unilateral injury causes hoarseness,while bilateral injury causes difficulty in breathing or even life-threatening glottis obstruction.Analyzing the root cause of the thyroid injury,firstly it is the anatomical factors of recurrent laryngeal nerve,namely the close and complex relationship between the recurrent laryngeal nerve and the inferior thyroid artery,the existence of branches of recurrent laryngeal nerve and its variation,and the presence of non recurrent laryngeal nerve and Zuckerkandl nodules.Those are all made the recurrent laryngeal nerve easy to be damaged.Secondly it is because of the vulnerability of the recurrent laryngeal nerve itself.Last improper using of energy operation instrument will cause heat injury on nerves.Below counter measures can be implemented to prevent recurrent laryngeal nerve injury.Dissect to show recurrent laryngeal nerve or make it ‘ visualization’ during thyroidectomy.Elaborately anatomize recurrent laryngeal nerve to appropriate degree.Be familiar with the property of energy operation instrument and thus safely use them to reduce the heat injury of recurrent laryngeal nerve.Reasonably use the intraoperative nerve monitoring in the surgery,which assist to reduce the risk of injury of recurrent laryngeal nerve.