CAJ | 학술논문

目的探讨腹腔镜胆囊切除术在腹部手术后高龄患者中应用的临床效果和安全性.方法将我院收治的曾有腹部手术史拟行腹腔镜胆囊切除术的高龄患者(年龄≥60岁)80例作为研究组,无腹部手术史行腹腔镜胆囊切除术的高龄患者80例作为对照组,两组患者均在气管插管静脉复合全身麻醉下行腹腔镜胆囊切除术,四孔法操作,CO2气腹压8～ 10 mmHg.结果研究组患者手术成功58例,22例中转开腹手术,平均手术时间(68±9)min;对照组患者手术成功70例,10例中转开腹手术,平均手术时间(48±3)min.结论多次腹部手术史的高龄患者行腹腔镜胆囊切除术手术难度加大,中转率增高,手术时间延长,但不应作为腹腔镜胆囊切除术的禁忌症.
목적 탐토복강경담낭절제술재복부수술후고령환자중응용적림상효과화안전성.방법 장아원수치적증유복부수술사의행복강경담낭절제술적고령환자(년령≥60세)80례작위연구조,무복부수술사행복강경담낭절제술적고령환자80례작위대조조,량조환자균재기관삽관정맥복합전신마취하행복강경담낭절제술,사공법조작,CO2기복압8～ 10 mmHg.결과 연구조환자수술성공58례,22례중전개복수술,평균수술시간(68±9)min;대조조환자수술성공70례,10례중전개복수술,평균수술시간(48±3)min.결론 다차복부수술사적고령환자행복강경담낭절제술수술난도가대,중전솔증고,수술시간연장,단불응작위복강경담낭절제술적금기증.
Objective To investigate the clinical efficacy and safety oflaparoscopic cholecystectomy (LC) in elderly patients after abdominal surgery.Methods 80 elderly patients (age ≥60 years) who had abdominal surgery undergoing LC were chosen as research group,80 elderly patients without abdominal surgery as control group,both groups were combined with general anesthesia endotracheal intubation vein downstream LC,four-hole method was used with CO2 gas abdominal pressure to 10 mmHg.Results The research group had 58 successful cases,the success rate was 72.5％,22 cases converted to laparotomy,transit rate was 27.5％,the average operative time was (68 ± 9) min; control group had 70 successful cases,the success rate was 87.5％.10 cases converted to laparotomy,transit rate was 12.5％,the average operative time was (48 ± 3) min.The laparoscopic surgery success rate of research group was significantly lower than that of control group,the transit rate was higher,the average operative time was longer than that in the control group (P＜0.05).Conclusion Multiple abdominal surgeries for elderly patients undergoing LC lead the increase of operative difficulty,increased transit rate,longer surgery time,but should not be used as a contraindication of LC.