临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2014年
14期
1203-1205
,共3页
老年人%胆石症%急性胆囊炎%保守治疗%手术治疗
老年人%膽石癥%急性膽囊炎%保守治療%手術治療
노년인%담석증%급성담낭염%보수치료%수술치료
Elderly%Gallstones%Acute cholecystitis%Conservative treatment%Surgical treatment
目的：探讨老年胆石症伴急性胆囊炎保守与手术治疗的选择。方法选择胆石症伴急性胆囊炎的老年患者170例为研究对象，手术治疗的患者纳入研究组（n ＝92），保守治疗的患者纳入对照组（n ＝78），比较两组临床症状完全缓解时间、住院时间、进食时间与肠功能恢复时间等治疗结果。结果术中发现胆囊结石共92例（100%），胆囊积脓26例（28.26%），胆囊坏疽11例（11.96%），胆汁性腹膜炎共6例（6.52%），并发胆总管结石共12例（13.04%）。研究组临床症状完全缓解时间、住院时间显著小于对照组，其余无显著差异。手术组患者均成功治疗，手术后并发上呼吸道感染6例，肺炎2例，心功能不全1例，无临床死亡。结论早诊断、早治疗，严格掌握手术适应证，在围手术期对基础疾病恰当处理，这些是老年急性胆囊炎伴胆石症治疗成功的关键。
目的：探討老年膽石癥伴急性膽囊炎保守與手術治療的選擇。方法選擇膽石癥伴急性膽囊炎的老年患者170例為研究對象，手術治療的患者納入研究組（n ＝92），保守治療的患者納入對照組（n ＝78），比較兩組臨床癥狀完全緩解時間、住院時間、進食時間與腸功能恢複時間等治療結果。結果術中髮現膽囊結石共92例（100%），膽囊積膿26例（28.26%），膽囊壞疽11例（11.96%），膽汁性腹膜炎共6例（6.52%），併髮膽總管結石共12例（13.04%）。研究組臨床癥狀完全緩解時間、住院時間顯著小于對照組，其餘無顯著差異。手術組患者均成功治療，手術後併髮上呼吸道感染6例，肺炎2例，心功能不全1例，無臨床死亡。結論早診斷、早治療，嚴格掌握手術適應證，在圍手術期對基礎疾病恰噹處理，這些是老年急性膽囊炎伴膽石癥治療成功的關鍵。
목적：탐토노년담석증반급성담낭염보수여수술치료적선택。방법선택담석증반급성담낭염적노년환자170례위연구대상，수술치료적환자납입연구조（n ＝92），보수치료적환자납입대조조（n ＝78），비교량조림상증상완전완해시간、주원시간、진식시간여장공능회복시간등치료결과。결과술중발현담낭결석공92례（100%），담낭적농26례（28.26%），담낭배저11례（11.96%），담즙성복막염공6례（6.52%），병발담총관결석공12례（13.04%）。연구조림상증상완전완해시간、주원시간현저소우대조조，기여무현저차이。수술조환자균성공치료，수술후병발상호흡도감염6례，폐염2례，심공능불전1례，무림상사망。결론조진단、조치료，엄격장악수술괄응증，재위수술기대기출질병흡당처리，저사시노년급성담낭염반담석증치료성공적관건。
Objective To explore the option of conservative or surgical treatment in elderly patients with acute cholecystitis and choleli-thiasis. Methods A total of 170 elderly patients with acute cholecystitis and cholelithiasis were enrolled in this study,they were divided into study group(n = 92)with surgical treatment and control group(n = 78)with conservative treatment. The outcomes of treatment including com-plete remission of symptoms,hospitalization days,duration for starting eating and duration for recovery of intestinal function were compared. Re-sults Gallbladder stones were found in 92 cases(100% ),empyema in gallbladder in 26 cases(28. 26% ),gallbladder gangrene in 11 cases (11. 96% )and bile peritonitis in 6 cases(6. 52% )were found during operation. A total of 12 cases(13. 04% )had concurrent common bile duct stones or bile duct stricture. Complete remission of clinical symptoms and hospitalization days in study group were less than those in control group,but no significant difference had been found in other items. All patients were successfully treated with operation,and 6 cases had concur-rent respiratory tract infection,2 cases had pneumonia and one case had cardiac insufficiency after operation. Conclusion Early diagnosis and treatment,mastering strict surgical indications and perioperative proper treatment are key points for successful treatment in elderly patients with acute cholecystitis and cholelithiasis.
