老年急性胆囊炎临床治疗方式分析

Analysis of Clinical Treatment of Elderly Patients with Acute Cholecystitis

目的探讨老年急性胆囊炎的临床特点及治疗方式。方法纳入老年急性胆囊炎患者175例,男71例,女104例;入院后均给予常规保守治疗,经非手术治疗胆囊炎症状未见缓解或加重,患者和(或)家属同意者采取手术治疗。79例患者行手术治疗。分析保守治疗与手术治疗的临床疗效。结果本组治愈或临床缓解170例(97.1%),死亡5例。非手术治疗者96例,症状缓解53.1%(93例/175例),非手术治疗者3.8%(3例/96例)死于多器官功能障碍综合征。手术治疗79例72h内行手术治疗74例均治愈,5例72h后采取手术治疗的患者,2例(2.5%)死于多器官功能障碍综合征。手术组住院时间较保守治疗组短[(11.8±5.3),(15.9±6.1)d,P<0.05]。结论选择合理的治疗方式和手术时机,并注重围手术期处理,老年急性胆囊炎外科手术治疗是安全可行的。

Objective To investigate the clinical characteristics of elderly patients with acute cholecystitis and treatment.Methods The patients included 175 cases of elderly patients with acute cholecystitis,71 cases of male and female 104 cases;admitted to hospital were treated with conventional conservative treatment,non-surgical treatment of cholecystitis and no ease or worsen the symptoms,the patient and（or）families consented to take surgery treatment.79 patients underwent surgery.Analysis of conservative therapy and surgical treatment of clinical efficacy.Results 170 cases of cure or clinical remission（97.1%）,5 cases died.Non-surgical treatment in 96 cases,relief of symptoms 53.1%（93 cases/175 cases）,non-surgical treatment were 3.8%（3 cases/96 cases）died of multiple organ dysfunction syndrome.Surgical treatment of 79 patients with surgical treatment of 72 h experts 74 cases were cured,5 cases taken after 72 h in patients treated with surgery,2 cases（2.5%）died of multiple organ dysfunction syndrome.Operation group,length of stay shorter than the conservative treatment group [（11.8 ± 5.3）,（15.9 ± 6.1）d,P〈0.05].Conclusion The selection of rational treatment and surgical timing,and focus on perioperative management,surgical treatment of elderly patients with acute cholecystitis is safe and feasible.