| 摘要: |
| 目的探讨老年急性非结石性胆囊炎患者早期行腹腔镜胆囊切除术的临床效果。方法回顾性分析我院2011年1月至2015年12月期间收治的95例老年急性非结石性胆囊炎患者的临床资料,以入院后立即行腹腔镜胆囊切除术者52例为研究组,以入院后保守治疗48h再行腹腔镜胆囊切除术者43例为对照组。比较两组的腹腔镜中转开腹情况、术中出血量、手术时间、术后并发症、住院时间、术后胆囊病理改变等。结果研究组中转开腹率为5.77%,低于对照组20.93%,差异有统计学意义(P<0.05);研究组术中出血量58.71mL,低于对照组84.90mL,差异有统计学意义(P<0.05);研究组手术时间64.64min,低于对照组77.30min,差异有统计学意义(P<0.05)。2组术后创面出血、肺部感染及切口感染等并发症的发生率,差异无统计学意义(P>0.05)。研究组住院时间8.02d,低于对照组14.73d,差异有统计学意义(P<0.05)。研究组胆囊病理变化以水肿及化脓性为主,分别为23.08%、59.62%;对照组以坏疽性改变为主,为67.44%,差异有统计学意义(P<0.05)。结论老年AAC容易发生胆囊坏疽,尽早诊断,早期实施LC,手术成功率更高,对机体创伤更小,有利于老年患者的早期康复。 |
| 关键词: 老年 急性非结石性胆囊炎 腹腔镜胆囊切除术 |
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| Early Laparoscopic Cholecystectomy for Elderly Patients with Acute Calculous cholecystitis |
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Chen Qixun;Jiang Ping
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Chengdu Tianfu New Area People’s Hospital
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| Abstract: |
| Objective To investigate the clinical effect of laparoscopic cholecystectomy( LC) in elderly patients with acute calculous cholecystitis.Methods The clinical data of 95 elderly patients with acute non-calculous cholecystitis treated in the Tianfu New District People’s Hospital of Chengdu from January 2011 to December 2015 were analyzed retrospectively. The 52 patients who underwent laparoscopic cholecystectomy after admission were selected as the study group,while 43 cases of laparoscopic cholecystectomy performed after conservative treatment for 48 h after admission were selected as the control group.The laparoscopic conversions to laparotomy,the amount of bleeding,the time of operation,the postoperative complications,the length of stay and the pathological changes of the gallbladder after operation were compared between the 2 groups. Results The laparotomy rate in the study group was 5. 77%,which was lower than 20. 93% in the control group,and the difference was statistically significant( P <0. 05).The amount of intraoperative bleeding in the study group was 58. 709. 13 ml,which was lower than that of the control group84. 9015. 65 ml,and the difference was statistically significant( P<0. 05).The study group operation time was 64. 6411. 68 min,lower than the control group77. 3011. 62 min,the difference was statistically significant( P<0. 05).There were no significant differences in the incidence of postoperative wound bleeding,pulmonary infection and incision infection between the 2 groups( P> 0. 05). The hospitalization time of the study group was 8. 021. 25 d,which was lower than that of the control group 14. 732. 54 d,and the difference was statistically significant( P<0. 05).The pathological changes of the gallbladder in the study group were mainly edema and purulent,23. 08% and 59. 62% respectively,mainly gangrene of 67. 44% in thecontrol group,and the difference was statistically significant,P<0. 05.Conclusion Elderly AAC is prone to gallbladder gangrene.And with the help of early diagnosis and early implementation of LC,the success rate of surgery is higher with less trauma to the body,which is conducive to the early rehabilitation of elderly patients. |
| Key words: elderly acutenon-calculouscholecystitis laparoscopiccholecystectomy |
