高龄急性坏疽性胆囊炎患者的临床诊治方法探讨

Clinical experience on treatment of acute gangrenous cholecystitis in elder patients

目的探讨高龄急性坏疽性胆囊炎患者的临床诊断和外科治疗方法。方法对收治的48例高龄(>70岁)急性坏疽性胆囊炎患者的临床资料进行回顾分析。结果本组48例病人,40例行外科手术治疗,其中胆囊切除术30例,胆囊大部切除术8例,胆囊造瘘术2例。保守治疗8例,其中3例因患感染中毒性休克、多器官功能衰竭死亡,3例自动出院,2例好转。结论结合临床体检与病史,以及B超,CT检查是诊断该病的主要方法;早期诊断、注重围手术期处理、采用简单有效的手术方式、并预防术后并发症能提高本病治愈率,减低手术风险。

Objective To investigate the diagnosis and surgical treatment of acute gangrenous cholecystitis in aging patients.Methods The clinical data of 48 acute gangrenous cholecystitis in aging patients（70 years old） were retrospectively analyzed.Results 40 patients received surgical treatment,including 30 cases with cholecystectomy,8 cases with subtotal cholecystectomy and 2 cases with cholecystostomy.8 patients received conservative treatment.3 patients died of toxic shock and multiple organ failure,3 patients were discharged automatically and 2 patients were alleviated in symptoms.Conclusions Combined with physical examination and medical history,Ultrasound and CT scanning are important methods in diagnosis.Early diagnosis,reasonable perioperative management,simple and safe surgical approach,as well as prevention of postoperative complications will improve the curability and decrease the operative risk.