老年患者胆囊切除术诊治及临床研究.docVIP

老年患者胆囊切除术诊治及临床研究[摘要] 目的 探讨不同情况下老年人胆囊疾病的治疗方法。 方法 回顾性分析2010年1月～2011年12月本院收治的131例60岁以上老年胆囊疾病患者的临床资料，对不同情况下采用的个体化治疗方法进行比较。 结果 131例患者中，腹腔镜胆囊切除（LC）27例，直接开腹（OC）103例，B超引导下经皮经肝胆囊穿刺引流（PTCD）1例。治愈129例，好转2例。 结论 对胆囊疾病老年患者，术前应全面掌握全身情况，认真分析胆囊的局部条件及病变性质，采用个体化治疗，可达到安全、微创治疗效果。胆囊疾患外科治疗必须完善围手术期处理，尽量避免急诊手术，减少并发症发生。 [关键词] 老年人；胆囊疾患；并发症；围术期 [中图分类号] R657.4 [文献标识码] B [文章编号] 1674-4721（2012）06（a）-0177-02 The diagnosis and treatment of elderly patients with cystic resection with experience CHENG Zheng YU Changchun Surgery Department of Wangjiang County Hospital in Anhui Province, Wangjiang 216200, China [Abstract] Objective To explore the treatment of old gallbladder disease under different conditions. Methods The clinical material of 131 cases of 60 years or older patients with gallbladder disease in our hospital from January 2010 to December 2012 was analyzed retrospectively, individual therapy methods in different conditions were compared. Results Among 131 cases, 27 cases were given laparoscopic cystic resection (LC), 103 cases were given direct open resection (OC), B ultrasonic guided percutaneous drainage by liver biopsy gallbladder (PTCD) in 1 case. And 129 cases were cured, 2 cases improved obviously. Conclusion We should grasp the whole preoperative condition of elderly patients with gallbladder disease, careful analyze the local conditions and gallbladder lesion properties, and give the individual therapy, then we can achieve safety, minimally invasive treatment effect. Gallbladder disease surgical treatment must perfect the perioperative management, try to avoid emergency surgery, reduce the complications. [Key words] Old people; Gallbladder diseases; Complication; Perioperative period 随着我国生活条件提高，医疗条件改善，人均寿命的延长，老年人的数量逐渐增加，随着人口老年化的趋势，发现近年来胆囊疾病发病呈增加趋势[1]，胆囊良性疾病是老年人的常见病和多发病之一，胆囊切除术是主要治疗方法。老年人因器官功能减退、免疫力低下、往往合并心、肺、肝、肾等多种疾病，使得老年性胆石症患者病情发展迅速，死亡率较年轻人高[2]。本科2010年1月～2011年12月共手术治疗823例胆石症患者，其中60岁以上131例，现报道如下： 1 资料与方法 1.1 一般资料 本组131例患者，男性29例，女性102例。年龄60～83岁，平均66.02岁。病史1 d～21