非手术治疗老年急性胆道感染的临床研究

Clinical study of non-surgical treatment of acute biliary tract infections in elderly patients

目的探讨非手术治疗和手术治疗老年急性胆道感染的临床效果,以期提高临床治疗水平。方法回顾性分析2010年2月-2013年2月118例老年急性胆道感染患者临床资料,根据不同治疗方法分成两组,对照组60例,采用非手术治疗;观察组58例,予以手术治疗,比较两组患者治疗后的临床效果、并发症的发生率、病死率等的差异。结果对照组的住院时间为(14.8±6.3)d,症状缓解时间为(7.2±2.3)d,平均医疗费用为(2521.8±994.4)元,复发例数为7例占11.67%,死亡11例占18.33%,有并发症7例占11.67%;观察组的住院时间为(12.9±5.9)d,症状缓解时间为(4.1±1.6)d,平均医疗费用为(5792.4±1193.3)元,复发2例占3.45%,死亡3例占5.17%,有并发症4例占6.90%,两组患者在住院时间比较差异无统计学意义,而在其他指标上比较差异有统计学意义(P<0.05);对照组愈合13例占21.67%,显效19例占31.67%,有效17例占28.33%,无效11例占18.33%,总有效率为81.67%;观察组愈合38例占65.52%,显效11例占18.97%,有效7例占12.07%,无效2例占3.44%,总有效率为96.56%,两组患者临床疗效比较差异有统计学意义(P<0.05)。结论尽管保守和手术治疗老年急性胆道感染均有较好的临床效果,但只要掌握好适应证,手术治疗对患者的预后更佳。

OBJECTIVE To investigate the clinical effect on the treatment of acute biliary tract infections in elderly patients between the non-surgical treatment and the surgical treatment so as to improve the level of clinical treatment. METHODS A total of 118 cases of elderly patients with acute biliary tract infections, who were treated in the hospital from Feb 201 to Feb 2013, were enrolled in the study and were divided into two groups according to the different treatment methods; totally 60 cases in the control group were given the non-surgical treatment, while the observation group was given the surgical treatment, then the clinical effect, incidence of complication, and mortality were compared between the two groups. RESULTS The lengthen of hospitalization was （14.8 ±6. 3）d in the control group, （12.9±5.9）d in the observation group; the time of symptom recovery was （7.2±2.3）d in the control group,（4.1±1.6）d in the observation group; the average medical cost was （2521.8±994.4） yuan in the control group, （5792.4±1193.3） yuan in the observation group; there were 7（11.67%） recurrent cases in the control group and 2 （3. 45%） cases in the observation group; 11 （18.33%）cases died in the control group, 3 （5.17%） cases in the observation group; there were 7（11.67%） cases with complication in the control group and 4（6.90%） cases in the observation group, the difference in the length of hospitalization between the two groups was not significant, while the difference in the other indicators between the two groups was significant （P〈 0.05）. In the control group,there were 13 （21.67%） cases healed, 19 （31.67%） cases valid, 17 （28.33%） cases effective, and 11 （18.33%） cases invalid, with the total effective rate of 81.67% ; in the observation group, there were 38 （65.52%） cases healed,ll （18.97%//oo） cases valid, 7 （12.07%） cases effective, and 2 （3.44%） cases invalid, with the total effective rate of 96.56 %, the difference in the clinical efficacy between the two groups was significant （P〈0.05）. CONCLUSION Both the conservative treatment and the surgical treatment can achieve good clinical effect on the treatment of acute biliary tract infections in the elderly patients, however, if the indications are grasped, the prognosis of the surgical treatment will be better.