腹腔镜胆囊切除术在老年患者中的应用及围手术期处理

Application and perioperative management of laparoscopic cholecystectomy in elderly patients

目的探讨腹腔镜胆囊切除术在老年患者中的应用及围手术期处理。方法选取2014年6月~2016年6月在我院进行腹腔胆囊切除术的老年患者60例作为观察对象(研究组),另抽取同期进行开腹胆囊切除术的老年患者60例作为对照组,比较两组患者的手术时间、下床活动时间、肛门排气时间、住院时间和术后并发症发生率。结果研究组患者的下床活动时间、手术时间、肛门排气时间以及住院时间均明显优于对照组患者,差异有统计学意义(P<0.05);两组患者在下肢静脉血栓、胆漏、切口感染和肺部感染等方面比较,差异无统计学意义(P>0.05);研究组并发症总发生率仅为5.00%,对照组并发症总发生率高达16.67%,组间比较差异有统计学意义(P<0.05)。对比两组患者治疗总满意度,研究组95.00%高于对照组85.00%,组间数据有统计学意义(P<0.05)。结论老年患者手术危险性增加,应加强围术期处理,老年患者进行腹腔镜胆囊切除术较传统开腹术安全、可靠、创伤小、术后恢复快,可促进患者康复。值得临床推广使用。

Objective To explore the application and perioperative management of laparoscopie cholecystectomy in elderly patients. Methods From June 2014 to June 2016,60 cases in our hospital for laparoscopic cholecystectomy in elderly patients were selected as the observation object （Study Group）,the other 60 cases for open cholecystectomy in elderly patients simultaneously were selected as the control group.The operative time,ambulation time,anal exhaust time,hospitalization time and the incidence of postoperative complications of two groups were compared. Results The ambulation time,operation time,anal exhaust time and hospitalization time of the study group were significantly better than that of the control group,the difference was statistically significant（P 〈 0.05）.The lower limb vein thrombosis,bile leakage,wound infection and pulmonary infection of two patients were compared,the difference was not statistically significant（P〉0.05）.The total complication rate in study group was 5.00%,The total complication rate of control group was 16.67%,there was significant differences between the groups（P 〈 0.05）.The total satisfaction of the two groups was compared,the study group was 95.00% higher than the control group（85.00%）,and the difference was statistically signifieant（P 〈 0.05）. Conclusion Elderly patients increased risk,we should strengthen the pcrioperative management,elderly patients with laparoseopic cholecystectomy compared with traditional open surgery is safe,reliable,less trauma,faster postoperative recovery,can promote the rehabilitation of patients.It is worthy of clinical promote.