摘要
目的 探讨内镜下支架放置术治疗老年人胆总管结石的应用价值。 方法 对 5 2例老年胆总管结石患者 (70～ 89岁 )进行回顾性分析 ,根据所行治疗方式分胆总管支架放置组 (支架组 ,2 8例 )和胆总管探查手术组 (手术组 ,2 4例 )。 2组患者具有基本相同的临床特征。术后随访 14～ 85个月。 结果 支架组患者手术全部成功 ;手术组有 1例于术后第 3天死于呼吸循环衰竭 ,手术死亡率为 4 2 %。支架组和手术组早期并发症发生率分别为 14 4 %和 33 3% (P <0 0 1) ;晚期并发症发生率分别为 39 3%和 12 5 % (P <0 0 1) ,支架组有 2例死于晚期并发症 ,病死率为 7 1% ,其中 1例为急性化脓性胆管炎 ,1例为肝脓肿。 结论 对老年人胆总管结石患者行胆总管内支架放置术为一种安全、有效的治疗手段 ,但远期疗效较差。只要患者身体条件允许 ,早期行胆总管探查术仍应为治疗手段的首选。
Objective To evaluate the effect of endoprostheses for short and long term management of common bile duct stones in elderly patients(70 89 years). Methods Fifty two patients over 70 years with common bile duct stones undergone endoscopic biliary stenting(Group S, 28 cases) or common bile duct exploration (Group D, 24 cases) were followed up for 14 85 months. The two groups were similar to each other in clinical manifestations. Results One patient (4 2%) died because of breath and circulation exhausting on the 3rd day postoperation in Group D. Early complications were 14 4% and 33 3% respectively ( P <0 01), while the late complications were 39 3% and 12 5%, respectively( P <0 01) in group S and group D. Two patients died of late complications in Group S, with the death rate being 7 1%. Conclusions For elderly patients with common bile duct stones, endoprostheses was proved a safe and effective means, but its future effect was worse than that of the operation. Therefore, the exploration operation for common bile duct should be firstly chosed if the patient conditions could tolerate the surgery.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2002年第3期188-190,共3页
Chinese Journal of Geriatrics
