中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
14期
28-30
,共3页
老年人%胆囊炎,急性%胆囊切除术,腹腔镜
老年人%膽囊炎,急性%膽囊切除術,腹腔鏡
노년인%담낭염,급성%담낭절제술,복강경
Aged%Cholecystitis,acute%Cholecystectomy,laparoscopic
目的 探讨老年急性胆囊炎腹腔镜胆囊切除术时机及治疗体会.方法 回顾性分析112例老年急性胆囊炎行腹腔镜胆囊切除术患者的临床资料,发病72 h内入院者60例(早期手术组),发病72 h以后入院者52例(晚期手术组).比较两组手术时间、术中出血量、术后肠功能恢复时间、腹腔引流量、中转开腹率、住院时间的差异.结果 晚期手术组手术时间、术中出血量、术后肠功能恢复时间、腹腔引流量、住院时间均高于早期手术组[(76.7±7.8) min比(54.3±4.8) min,(41.2±5.9) ml比(25.2±6.5)ml,(2.2±0.7)d比(1.4±0.6)d,(49.6±7.2)ml比(48.7±6.9)ml,(6.4±0.7)d比(3.9±0.6)d],差异有统计学意义(P＜0.05).两组中转开腹率比较差异无统计学意义[11.5％(6/52)比3.3％(2/60),P＞0.05].结论 老年急性胆囊炎病情进展快,治疗难度大,风险高,早期采取腹腔镜胆囊切除术可明显缩短手术时间和住院时间,促进患者术后恢复.
目的 探討老年急性膽囊炎腹腔鏡膽囊切除術時機及治療體會.方法 迴顧性分析112例老年急性膽囊炎行腹腔鏡膽囊切除術患者的臨床資料,髮病72 h內入院者60例(早期手術組),髮病72 h以後入院者52例(晚期手術組).比較兩組手術時間、術中齣血量、術後腸功能恢複時間、腹腔引流量、中轉開腹率、住院時間的差異.結果 晚期手術組手術時間、術中齣血量、術後腸功能恢複時間、腹腔引流量、住院時間均高于早期手術組[(76.7±7.8) min比(54.3±4.8) min,(41.2±5.9) ml比(25.2±6.5)ml,(2.2±0.7)d比(1.4±0.6)d,(49.6±7.2)ml比(48.7±6.9)ml,(6.4±0.7)d比(3.9±0.6)d],差異有統計學意義(P＜0.05).兩組中轉開腹率比較差異無統計學意義[11.5％(6/52)比3.3％(2/60),P＞0.05].結論 老年急性膽囊炎病情進展快,治療難度大,風險高,早期採取腹腔鏡膽囊切除術可明顯縮短手術時間和住院時間,促進患者術後恢複.
목적 탐토노년급성담낭염복강경담낭절제술시궤급치료체회.방법 회고성분석112례노년급성담낭염행복강경담낭절제술환자적림상자료,발병72 h내입원자60례(조기수술조),발병72 h이후입원자52례(만기수술조).비교량조수술시간、술중출혈량、술후장공능회복시간、복강인류량、중전개복솔、주원시간적차이.결과 만기수술조수술시간、술중출혈량、술후장공능회복시간、복강인류량、주원시간균고우조기수술조[(76.7±7.8) min비(54.3±4.8) min,(41.2±5.9) ml비(25.2±6.5)ml,(2.2±0.7)d비(1.4±0.6)d,(49.6±7.2)ml비(48.7±6.9)ml,(6.4±0.7)d비(3.9±0.6)d],차이유통계학의의(P＜0.05).량조중전개복솔비교차이무통계학의의[11.5％(6/52)비3.3％(2/60),P＞0.05].결론 노년급성담낭염병정진전쾌,치료난도대,풍험고,조기채취복강경담낭절제술가명현축단수술시간화주원시간,촉진환자술후회복.
Objective To explore the operation time and experience of laparoscopic cholecystectomy in elderly patients with acute cholecystitis.Methods The clinical data of 112 elderly patients with acute cholecystitis were retrospectively analyzed,the patients were treated with laparoscopic cholecystectomy.According to the operation time,the patients were divided into early operation group (60 cases,the incidence of operation within 72 h) and advanced operation group (52 cases,the incidence of operation beyond 72 h).The operation time,intraoperative bleeding volume,postoperative intestinal function recovery time,abdominal drainage volume,conversion rate and length of stay in hospital were compared between the 2 groups.Results The operation time,intraoperative bleeding volume,postoperative intestinal function recovery time,abdominal drainage volume and length of stay in hospital in advanced operation group were significantly worse than those in early operation group [(76.7 ± 7.8) min vs.(54.3 ± 4.8) min,(41.2 ± 5.9) ml vs.(25.2 ± 6.5) ml,(2.2 ± 0.7) d vs.(1.4 ± 0.6) d,(49.6 ± 7.2) ml vs.(48.7 ± 6.9) ml,(6.4 ± 0.7) d vs.(3.9 ± 0.6) d],there were statistical differences (P ＜ 0.05).There was no statistical difference in the conversion rate between the 2 groups [11.5％ (6/52) vs.3.3％ (2/60),P ＞ 0.05].Conclusions The pathogenetic condition progress of acute cholecystitis in the elderly patients is quickly,and the treatment is very difficuh,high risk.Early laparoscopic cholecystectomy can shorten the operation time and length of stay in hospital,promote postoperative recovery.
