老年急性胆囊炎患者心电图特点及其治疗策略研究

The features of electrocardiogram in senile patients with acute cholecystitis and its treatment strategy

目的分析老年急性胆囊炎患者心电图特点及其治疗策略,为临床治疗提供指导。方法收集我院2018年9月—2019年10月收治的100例老年急性胆囊炎患者的临床资料,所有患者入院后均完善心电图、胆囊及心脏超声检查,统计心电图检查结果,分析其心电图特点,并统计患者临床治疗情况与结果。结果入选100例患者中,保守治疗12例(12.00%),3例死亡(25.00%);行外科急诊胆囊切除术88例(88.00%),死亡2例(2.27%);术后切口感染4例(4.55%),胆瘘1例(1.14%)。入选100例老年急性胆囊炎患者中,治疗前83例患者心电图异常,占83.00%,治疗后12例心电图异常,占12.63%;治疗前后ST段改变、T波改变、窦性心动过速、房性早搏异常情况对比,差异有统计学意义(P<0.05);治疗前后窦性心动过缓、室性早搏异常情况对比,差异无统计学意义(P>0.05)。结论老年急性胆囊炎患者心电图异常改变多以ST段改变、T波改变、窦性心动过速为主,临床治疗需综合多种检查结果,选取最佳手术或保守治疗手段,以获得良好疗效。

Objective To analyze the features of electrocardiogram in senile patients with acute cholecystitis and its treatment strategy,and to provide guidance for clinical treatment.Methods The clinical data of 100 senile patients with acute cholecystitis who were admitted in the hospital from September 2018 to October 2019 were retrospectively collected.All the patients underwent electrocardiogram,gallbladder and cardiac ultrasound examinations after admission.The results of electrocardiogram examination of all the patients were recorded,the features of electrocardiogram were analyzed,and the clinical treatment and results of patients were recorded.Results There were 12 cases of conservative treatment(12.00%)and 3 cases of death(25.00%)among the 100 selected patients;There were 88 cases of cholecystectomy(88.00%)and 2 cases of death(2.27%);There were 4 cases of postoperative incision infection(4.55%)and 1 case(1.14%)of biliary fistula.Among the 100 selected senile patients with acute cholecystitis,there were 83 cases(83.00%)of abnormal electrocardiogram before treatment and 12 cases(12.63%)of abnormal electrocardiogram after treatment;The ST segment changes,T wave changes,sinus tachycardia,and abnormal atrial premature beats were compared before and after treatment,and the difference was statistically significant(P<0.05);There was no statistically significant difference in the sinus bradycardia and abnormal ventricular premature beat before and after treatment(P>0.05).Conclusion The abnormal changes of electrocardiogram in senile patients with acute cholecystitis are mainly ST segment changes,T wave changes,and sinus tachycardia.Clinical treatment needs to integrate a variety of examination results,and select the best surgical procedure or conservative treatment,so as to play a good therapeutic effect.