摘要
目的探讨老年胆囊结石换则的临床特点及外科诊断治疗。方法回顾性分析2006年1月至2009年4月50例老年胆囊结石患者的临床资料。结果术前充分准备,治疗基础疾病;急诊手术9例,择期手术41例,根据结石分布范围采用行单纯胆囊切除术39例、胆总管切开取石术加T管引流术7例、胆囊切除术胆总管切开取石术加T管引流术4例。全组患者均完成手术,术中无死亡;治愈49例,死亡1例,为急诊手术后感染中毒性休克死亡;手术并发症6例:呼吸道感染4例、切口裂开1例、泌尿系感染1例,经对症治疗治愈。住院11～34d,平均(15.9±4.5)d。结论老年人胆石症的外科治疗应针对老年人胆管疾病的特点,必须完善围手术期处理,选择合适的手术时机和手术方式,尽量避免急诊手术以提高手术治愈率,减少并发症的发生。
Objective To explore the clinical characteristics and surgical diagnosis and treatment of gallstones in the elderly. Method Form January 2006 to April 2009, retrospective analysis 50 cases of gallstones in elderly patients with clinical data. Result Fully prepared for preoperative treatment based on disease; nine cases of emergency surgery, 41 cases of surgery, according to the distribution of the scope of the use of stone lines alone 39 cases of cholecystectomy, common bile duct lithotomy plus T tube drainage in 7 cases, gall bladder cholecystectomy lithotomy incision Explorer plus T-tube drainage in 4 cases. All patients completed surgery, no intraoperative deaths; 49 cases of cure, one cases of death, emergency surgery for toxic shock after the death of infection; 6 cases of postoperative complications： 4 cases of respiratory tract infection, wound dehiscence in 1 case, urinary tract one cases of infection, cured by symptomatic treatment. 11 -34 days of hospitalization, the average （15.9±4.5） days. Conclusion Surgical treatment of cholelithiasis in the elderly should be the characteristics of biliary tract disease in the elderly, we must improve the perioperative management, select the appropriate timing of surgery and surgical approach to avoid emergency surgery to improve cure rate and reduce complications.
出处
《中国医药指南》
2009年第18期32-33,共2页
Guide of China Medicine
关键词
老年人
胆结石
胆囊炎
外科治疗
The elderly
Gallstones
Cholecystitis
Surgical treatment
