摘要
目的 探讨老年急性结石性胆囊炎（ACC）的腹腔镜手术技巧,以期提高其腹腔镜手术治疗效果。方法 自2013年6月至2016年5月收治85例老年ACC患者,根据其是否具有手术指征,分为手术组（46例）和非手术组（39例）,对比观察两组治疗效果,并对发病早期（〈72 h）与发病晚期（〉72 h）实施腹腔镜胆囊切除术（LC）的手术效果（手术时间、术中出血量、住院天数）、术后并发症和治疗效果进行分析。采用SPSS 18.0软件进行统计学处理;手术效果指标以均数±标准差（x珋±s）表示,采用t检验进行比较;术后并发症、疗效指标以率（%）表示,组间比较采用χ^2检验;P〈0.05表示差异有统计学意义。结果 85例老年ACC患者平均年龄是（74.8±8.2）岁。全部患者治愈70例,治愈率82.4%;好转12例,好转率14.1%;死亡3例,病死率3.5%。手术组疗效明显强于非手术组,差异有统计学意义（χ^2=11.828,P=0.003）。40例LC的成功率及治愈率均达到100%。发病早期与晚期实施LC的手术效果、术后并发症差异无统计学意义（P〉0.05）。非手术组ACC复发率84.2%。结论 老年ACC患者腹腔镜胆囊切除术是安全可行的,关键在于确定科学合理的手术指征、熟练掌握腹腔镜手术技巧、加强围手术期治疗,以期进一步提高老年ACC患者的腹腔镜手术治疗效果。
Objective To investigate the skills of laparoscopic cholecystectomy （LC） in elderly patients with acute calculous cholecystitis （ACC）, so as to improve the therapeutic effects of LC. Methods The clinical data of 85 elderly patients with ACC were collected from June 2013 to May 2016 in our hospital. According to whether it had operative indications, the patients were divided into surgical group （46 cases） and non operative group （39 cases）. The therapeutic effects of the two groups were compared and observed. The operative effects （operation time, blood loss, length of stay in hospital） , postoperative complications and therapeutic： effects of LC were analyzed in the early stage （ 〈72 h） and the late stage （ 〉 72 h）. SPSS 18.0 software was performed for statistics. The data of operative effects was shown as mean and standard deviation （x ± s） , and t test was used to compare the early group and the late group. The postoperative complications and efficacy were expressed as the rate （ % ）, and test was used for comparison between the two groups. A P value 〈 0.05 was considered statistically significant. Results The average age of 85 elderly patients with ACC patients was 74.8 ± 8.2 years old. 70 cases were cured, with the cure rate of 82.4% ; 12 cases improved, with the improvement rate of 14.1% ; 3 cases died, the mortality rate of 3.5%. The therapeutic efficacy in the surgical group was significantly better than that in the non operative group （χ^2 = 11. 828, P = 0. 003）. The success rate and cure rate in 40 cases of LC were 100%. Comparing the early group with the late group, there was no significant difference in the operative effects and postoperative complications of LC （P 〉 0.05 ）. The recurrence rate of ACC was 84.2% in the non-operative group. Conclusions LC in elderly patients with ACC is safe and feasible. The key point of this treatment is to determine the scientific and reasonable operative indications, skilled master the skills of LC, strengthen
出处
《中华普外科手术学杂志（电子版）》
2016年第6期466-468,共3页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
国家电网公司科技基金资助项目(SGHB0000AJJS1400182)~~
关键词
胆囊结石病
胆囊炎
胆囊切除术
腹腔镜
Cholecystolithiasis
Cholecystitis
Cholecystectomy, laparoscopic
