中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2014年
27期
42-43
,共2页
老年%坏疽%胆囊炎%手术%效果
老年%壞疽%膽囊炎%手術%效果
노년%배저%담낭염%수술%효과
Elderly%Gangrene%Cholecystitis%Operation%Effect
目的：探讨在基层医院手术治疗老年急性坏疽性胆囊炎的治疗时机及效果。方法：2008年6月-2013年6月收治急性坏疽性胆囊炎老年患者34例，对其临床资料进行回顾性分析。结果：术中探查发现胆囊坏疽并穿孔9例，单纯胆囊坏疽25例。32例患者顺利完成胆囊切除术，2例患者行经皮胆囊造口术。手术时间(96.1±29.2)min，术中出血量(80.6±45.4)mL，术后并发症：切口感染2例，换药后痊愈，2例术后出现少许胆漏，予以充分引流及抗炎治疗后自行愈合，肺部感染3例，予以抗炎对症治疗；肠道恢复时间(3.2±0.6)d；术后住院时间(7.5±3.6)d，院内死亡2例，1例死于呼吸衰竭，1例死于多器官功能衰竭。随访3～24个月，平均随访14个月，无胆道残留结石、胆道狭窄等严重并发症发生。结论：把握好良好的治疗时机，手术是基层医院治疗老年急性坏疽性胆囊炎安全有效的方法，值得推广。
目的：探討在基層醫院手術治療老年急性壞疽性膽囊炎的治療時機及效果。方法：2008年6月-2013年6月收治急性壞疽性膽囊炎老年患者34例，對其臨床資料進行迴顧性分析。結果：術中探查髮現膽囊壞疽併穿孔9例，單純膽囊壞疽25例。32例患者順利完成膽囊切除術，2例患者行經皮膽囊造口術。手術時間(96.1±29.2)min，術中齣血量(80.6±45.4)mL，術後併髮癥：切口感染2例，換藥後痊愈，2例術後齣現少許膽漏，予以充分引流及抗炎治療後自行愈閤，肺部感染3例，予以抗炎對癥治療；腸道恢複時間(3.2±0.6)d；術後住院時間(7.5±3.6)d，院內死亡2例，1例死于呼吸衰竭，1例死于多器官功能衰竭。隨訪3～24箇月，平均隨訪14箇月，無膽道殘留結石、膽道狹窄等嚴重併髮癥髮生。結論：把握好良好的治療時機，手術是基層醫院治療老年急性壞疽性膽囊炎安全有效的方法，值得推廣。
목적：탐토재기층의원수술치료노년급성배저성담낭염적치료시궤급효과。방법：2008년6월-2013년6월수치급성배저성담낭염노년환자34례，대기림상자료진행회고성분석。결과：술중탐사발현담낭배저병천공9례，단순담낭배저25례。32례환자순리완성담낭절제술，2례환자행경피담낭조구술。수술시간(96.1±29.2)min，술중출혈량(80.6±45.4)mL，술후병발증：절구감염2례，환약후전유，2례술후출현소허담루，여이충분인류급항염치료후자행유합，폐부감염3례，여이항염대증치료；장도회복시간(3.2±0.6)d；술후주원시간(7.5±3.6)d，원내사망2례，1례사우호흡쇠갈，1례사우다기관공능쇠갈。수방3～24개월，평균수방14개월，무담도잔류결석、담도협착등엄중병발증발생。결론：파악호량호적치료시궤，수술시기층의원치료노년급성배저성담낭염안전유효적방법，치득추엄。
Objective:To investigate the therapeutic time and effect of treatment of elderly patients with acute gangrenous cholecystitis in basic hospital operation.Methods:34 senile patients with acute gangrenous cholecystitis were selected from June 2008 to June 2013.We retrospectively analyzed the clinical data of them.Results:The intraoperative exploration found gallbladder gangrene and perforation in 9 cases,simple gallbladder gangrene in 25 cases.32 cases were successfully completed cholecystectomy;2 cases underwent percutaneous cholecystostomy.The operation time was(96.1 ± 29.2)minutes;the amount of bleeding during operation was(80.6±45.4)ml.The postoperative complications:wound infection in 2 cases,but they were cured after changed the dressing;2 cases had postoperative biliary leakage appears a little.They were self healing after we give sufficient drainage and anti-inflammatory treatment.3 cases of lung infection,they were given the anti-inflammatory symptomatic treatment. The intestinal recovery time was(3.2±0.6) days.The hospitalization time after operation was(7.5±3.6) days.2 cases died in the hospital,in which 1 case died of respiratory failure,and 1 cases died of multiple organ failure.Patients were followed up for 3~24 months,average 14 months of follow-up.There were no residual biliary tract stones,biliary stricture and other serious complications.Conclusion:We should grasp the good opportunity of treatment.In primary hospital operation,it is a safe and effective method in treatment of elderly patients with acute gangrenous cholecystitis,so it is worthy of promotion.
