CAJ | 학술논문

目的：探讨腹腔镜胆囊切除术在老年患者的临床应用疗效并对并发症危险因素进行研究。方法根据治疗方法的不同将230例胆囊切除术老年患者分为开腹手术组（62例）及腹腔镜手术组（168例），比较两组手术效果及术后胃肠功能恢复情况。同时采用Logistic回归分析腹腔镜胆囊切除术并发症危险因素。结果腹腔镜手术组手术时间、术中出血量、引流量、下床活动时间及住院天数显著少于开腹手术组（ P＜0．05）；术后肛管排气时间及肠鸣音恢复时间显著早于开腹手术组（P＜0．05）；腹腔镜手术组共有13例（7．7％）患者发生术后并发症。胆囊壁厚、白细胞计数、Calot三角粘连、胆囊颈部结石嵌顿是腹腔镜术后并发症的风险因素，Calot三角粘连是术后并发症的独立风险因素。结论老年患者行腹腔镜胆囊切除术治疗对机体损伤小、术后恢复快，Calot三角粘连是术后并发症的独立风险因素。
목적：탐토복강경담낭절제술재노년환자적림상응용료효병대병발증위험인소진행연구。방법근거치료방법적불동장230례담낭절제술노년환자분위개복수술조（62례）급복강경수술조（168례），비교량조수술효과급술후위장공능회복정황。동시채용Logistic회귀분석복강경담낭절제술병발증위험인소。결과복강경수술조수술시간、술중출혈량、인류량、하상활동시간급주원천수현저소우개복수술조（ P＜0．05）；술후항관배기시간급장명음회복시간현저조우개복수술조（P＜0．05）；복강경수술조공유13례（7．7％）환자발생술후병발증。담낭벽후、백세포계수、Calot삼각점련、담낭경부결석감돈시복강경술후병발증적풍험인소，Calot삼각점련시술후병발증적독립풍험인소。결론노년환자행복강경담낭절제술치료대궤체손상소、술후회복쾌，Calot삼각점련시술후병발증적독립풍험인소。
Objective To understand the effects of laparoscopic cholecystectomy and the factors that cause postoperative complications in the process of treating elderly patients . Method 230 elderly cases undergoing laparoscopic cholecystectomy were selected as research subjects .The patients were divided into open abdominal operation group ( 62 cases) and laparoscopic operation group (168 cases) based on operative Method .The operation effect and recovery of gastrointestinal function were compared between the two groups .Risk factors of the operation-related complications were studied by Logistic regression analysis .Findings Laparoscopic surgery operative time , blood loss, drainage flow, leaving bed time and hospital stay were significantly less than the open surgery group ( P <0.05);postoperative anal exhaust time and time needed for intestinal voice restoration were significantly earlier than the open surgery group ( P <0.05 );Postoperative complications was 7.7%( 13 cases) in the laparoscopic operation group .Univariate analysis showed that the thickness of gallbladder wall , leukocyte count , Calot triangle adhesion and gallbladder calculus were the risk factors for postoperative complications; Logistic regression analysis showed that Calot triangle adhesion was the independence risk factors for postoperative complications .Conclusion Laparoscopic cholecystectomy in elderly patients has less injury for body and faster recovery .Calot triangle adhesion was the independent risk factors for postoperative complications .