摘要
目的探讨应用损伤控制性手术治疗老年人梗阻性胆道疾病是否可减少术后并发症发生率和术后病死率，是否可提高老年人梗阻性胆道疾患者的手术安全性。方法将278例老年梗阻性胆道疾病患者，根据其接受手术方法的不同，分为损伤控制性手术组和确定性手术组。根据梗阻性疾病的良恶性分层分析，比较其应用损伤控制性手术和确定性手术治疗后的并发症发生率和术后病死率。结果损伤控制性手术组118例，术后并发症发生率为9．32％，术后病死率为0；确定性手术组160例，术后并发症发生率为24．38％，术后病死率为6．88％，两组比较，差异均有统计学意义，均为P〈0．01。良性梗阻性胆道疾病患者应用损伤控制性手术治疗组的并发症发生率为17．3％，术后病死率为0；确定性手术治疗组分别为16．3％和4．34％，两组比较，差异无统计学意义（均为P〉0．05）。恶性梗阻性胆道疾病患者应用损伤控制性手术治疗组的术后并发症发生率为4．45％，术后病死率为0；应用确定性手术治疗组分别为35．29％和10．29％，两组比较，差异均有统计学意义，分别为P〈0．01和P〈0．05。结论损伤控制性手术可降低老年人梗阻性胆道疾病手术的并发症发生率和术后病死率，提高老年梗阻性胆道疾病患者的手术安全性。
Objective To evaluate the efficacy and safety of the damage-controlling surgery for the elderly patients with obstructive biliary diseases. Methods 278 elderly patients with obstructive biliary diseases were divided into the damage-controlling surgery group and definite surgery group. The obstructive biliary diseases were divided into the benign obstructive group and the malignant obstructive group. The complication rate and mortality between the 2 groups were analyzed and compared. Results One hundred and eighteen elderly patients were treated by damage-contolling surgery, its complication rate was 9.32% and the mortality was 0%. One hundred and sixty elderly patients were treated by definite surgery, its complication rate was 24.38%, the mortality was 6.88%. There were significant differences in complication rate and mortality between the damage-controlling surgery group and the definite surgery group （all P〈0.01）. The complication rate of the benign obstructive diseases group treated by damage-controlling surgery was 17.3%, the mortality was 0%. The complication rate of the benign obstructive diseases group treated by definite surgery was 16.3 %, the mortality was 4.34 %. There was no significant difference in the complication rate and mortality between the 2 groups （all P〉0.05）. The complication rate and mortality of the malignant obstructive biliary diseases group treated by damage-controlling surgery were 4.45% and 0 % respectively, and were 35.29 % and 10.29 % by definite surgery, there were significant differences in the complication rate and mortality between the 2 groups （P〈0.01 and P〈0. 05）. Conclusions Damage-controlling surgery may decrease the complication rate and mortality of the elderly patients with obstructive biliary diseases, and improve the operation safety of the elderly patients.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2008年第5期352-354,共3页
Chinese Journal of Geriatrics
