高原地区老年患者腹腔镜与开腹胆囊切除术心肺并发症的临床比较

Laparoscopic versus Open Cholecystectomy in Aged Patients in Plateau Region:A Clinical Comparison of Cardiopulmonary Complications

目的 评价高原地区老年患者行腹腔镜胆囊切除术的安全性. 方法 2005年1月～2006年6月,长期居住于本地区的64例老年胆囊疾病患者,分别接受开腹胆囊切除术（open cholecystectomy,OC）32例和腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC）32例,对手术后出现的心肺并发症进行统计. 结果 LC组急性肺水肿1例,慢性右心衰竭1例,肺部感染1例;OC组左心衰竭肺水肿3例,右心衰竭2例,肺部感染5例.LC组心肺并发症发生率明显低于OC组（9% vs 31%,χ^2=4.730,P=0.030）. 结论在高海拔、低气压和低氧分压环境下,老年患者LC并发症少,相对安全.

Objective To evaluate the safety of laparoscopic cholecystectomy＇ s in aged patients in plateau region. Method From January 2005 to June 2006, a total of 64 local aged gallbladder disease patients were included, in which 32 cases received open cholecystectomy （OC） and 32 cases received laparoscopic cholecystectomy （LC）. Postoperative cardiopulmonary complications were compared. Results In the LC group, 1 case of acute pneumonedema, 1 case of chronic right heart failure and 1 case of pulmonary infection occurred ; and 3 cases of left heart failure accompanied with pneumonedema, 2 cases of right heart failure and 5 cases of pulmonary infection occurred in the OC group. The incidence of cardiopulmonary complications of the LC group was significantly lower than that of the OC group （9% vs 31% ,χ^2 = 4. 730, P = 0. 030）. Conclusions In the circumstances of high altitude, low atmospheric pressure and low oxygen partial pressure, LC is safer than OC for aged patients in regard to postoperative complications.