老年人胆囊炎胆囊结石368例临床分析

Clinic Analysis of 368 Cases of elder with Cholelithiasis and Cholecystitis

老年人胆囊结石患者及胆囊结石合并胆囊癌者均逐年增多。本文分析了１９９０年至１９９２年收治的３６８例６０岁以上老年人胆囊炎胆囊结石患者。手术治疗２９３例，急诊手术占４．１％，误诊率为４．７％，手术死亡率为１％。术前检查有心、肺、肝、肾等合并疾患者占３２％。临床表现不典型，对于上腹部疼痛者常规Ｂ超检查有助于降低误诊率。提高手术治愈率、降低死亡率和并发症的关键因素之一是积极治疗合并疾患，充分作好术前准备后，早期施行手术治疗。

The incidence of cholelithiasis and coincide with gallbladder ma- lignant tumors of old people are increased in recent years.We have analysedclinic data of 368 cholelithiasis and cholecystitis of old people(over 60 years). They were admitted in our hospital in 3 years(1990-1992).293 cases weretreated with operations.Among these cases 4.1%were emergency operations,misdiagnosis rate were 4.7%,operative mortality were 1%,preoperativeexaminations demonstrated that there 32%patients complicated with cardiac,pneumal,hepatic,nephric and other disorders.Clinic expressions were atypical,routine B model ultrasound examinations to person who suffered fromupper abdominal pain may be helpful to decrease the misdiagnosis rate. Thekey factors to increase operative curing rate,decrease the mortality and therate of complications were to treat the complicated disorders,to have a betterpreoperative preparations,and to perform operative in early stage of thedisease.