老年不同类型胆道结石合并胆道感染的腹腔镜术后效果观察

The Effect of Laparoscopic Surgery on Different Types of Biliary Calculi Complicated With Biliary Tract Infection in the Elderly

目的探讨老年胆道结石患者与胆道感染的临床诊治疗效果与特点。方法选取我院2016年6月—2017年6月收治的116例老年胆道结石合并胆道感染的患者作为研究对象。按照病情轻重程度,将其分为Ⅰ组、Ⅱ组、Ⅲ组。急性重症胆道感染16例患者作为Ⅰ组,先兆型急性重症胆道感染24例患者作为Ⅱ组,轻症胆道感染76例患者作为Ⅲ组,结合患者具体情况,选择合适的手术治疗方法,将三组患者的住院时间、术后胆道残石率、临床疗效进行对比分析。结果术后及ICU住院时间Ⅰ组住院时间长于Ⅱ组和Ⅲ组,Ⅱ组长于Ⅲ组;Ⅰ组有1例患者发生死亡,Ⅱ组、Ⅲ组均无死亡现象发生;且Ⅲ组术后胆道残石率低于Ⅱ、Ⅰ组,差异具有统计学意义(P <0.05)。结论轻症胆道感染患者经腹腔镜切除术治疗临床效果显著,具有一定的临床应用价值。

Objective To investigate the clinical efficacy and characteristics of elderly patients with biliary calculi and biliary tract infections. MethodsFrom June 2016 to June 2017, 116 elderly patients with biliary calculi and biliary tract infection were selected as the study subjects. According to the severity of the disease, they were divided into group Ⅰ, group Ⅱ and group Ⅲ. 16 patients with acute severe biliary tract infection were treated as group I. 24 patients with threatened acute severe biliary tract infection were treated as group Ⅱ. 76 patients with mild biliary tract infection were treated as group Ⅲ. According to the specific conditions of the patients, the appropriate surgical treatment was selected. The hospitalization time, the rate of bile duct residual stone and the clinical effect of the three groups were compared and analyzed. Results The hospitalization time of group Ⅰ was longer than that of group Ⅱ and group Ⅲ, and that of group Ⅱ was higher than that of group Ⅲ. One patient died in group Ⅰ, and no death occurred in group Ⅱ or group Ⅲ. The residual stone rate of biliary tract in group Ⅲ was lower than that in group Ⅱ and group Ⅰ, and the difference was statistically significant(P < 0.05). Conclusion The clinical effect of laparoscopic resection in patients with mild biliary infection is significant.