老年结石性急性胆囊炎手术治疗分析

Analysis of surgical treatment of calculous acute cholecystitis in the elderly

目的:探讨老年结石性急性胆囊炎临床特点及手术治疗体会。方法:2017年2月-2020年2月收治老年结石性急性胆囊炎患者86例,对其临床特点进行回顾性分析。结果:经手术治疗治愈83例(97.78%),死亡3例(2.22%),发生并发症12例(16.7%)。3例患者均死于感染性休克,多脏器衰竭。结论:老年结石性急性胆囊炎术前易误诊,应早期诊断,早期治疗,根据病情及老年人对急性胆囊手术的耐受力,手术是治疗的主要方法,选择气管插管全麻。选择恰当的手术时机和手术方式,以提高手术的成功率,加强围术期管理是提高治愈率的关键,降低并发症的发生率,降低死亡率,提高临床治疗效果。

Objective:To explore the clinical characteristics and surgical treatment of calculous acute cholecystitis in the elderly.Methods:From February 2017 to February 2020,86 elderly patients with acute calculous cholecystitis were selected,their clinical characteristics were retrospectively analyzed.Results:After surgical treatment,83 cases(97.78%)were cured,3 cases(2.22%)died,and 12 cases(16.7%)had complications.All 3 patients died of septic shock and multiple organ failure.Conclusion:Elderly calculous acute cholecystitis is easy to be misdiagnosed before surgery.Early diagnosis and early treatment should be performed.According to the condition and the elderly's tolerance to acute gallbladder surgery,surgery is the main method of treatment,and general anesthesia is selected for tracheal intubation.Choosing the appropriate timing and method of surgery to improve the success rate of surgery,strengthening the perioperative management is the key to improving the cure rate,reducing the incidence of complications,reducing the mortality rate,and improving the clinical treatment effect.