高龄患者腹腔镜胆囊切除术围手术期处理(附70例临床分析)  

Perioperative management of over 80 years old patients for laparoscopic cholecystectomy analysis of seventy cases

作　　者：杨路[1] 纳涛[1] 王文昌[1] 

机构地区：[1]宁夏回族自治区银川市第一人民医院肝胆外科,750001

出　　处：《中华损伤与修复杂志（电子版）》2010年第3期45-47,共3页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的探讨80岁以上高龄患者行腹腔镜胆囊切除术围手术期的处理。方法回顾分析70例80岁以上高龄患者行腹腔镜胆囊切除术围手术期的处理措施。结果行腹腔镜胆囊切除术68例,中转开腹2例,手术时间35～145min,平均45min,住院时间4～8d,平均5d,术后无死亡病例及严重并发症发生。5例发生肺部感染,经积极对症、抗炎及支持治疗等痊愈。4例出现皮下气肿,1～3d后均自行吸收。术后随访1个月,所有病例情况良好,饮食恢复正常,检查腹部B超和肝功能正常,无残留结石。结论 80岁以上高龄患者行腹腔镜胆囊切除术风险大,难度高,但只要作好充分的术前准备,手术谨慎操作,术后严格管理,有针对性处理围手术期的各种问题,高龄患者行腹腔镜胆囊切除术是安全可行的。Objective To explore perioperative management of over 80 years old patients for laparoscopic cholecystectomy（LC）.Methods Clinical data of Seventy aged patients who underwent LC were collected and analyzed retrospectively.Results LC was successfully performed on 68 patients,and 2 converted to open surgery.The operation time was 35-145 min（average 45 min）,and the hospitalization was 4-8 d（average 5 d）.No death and serious complications occurred.Conclusions Though with more difficulties and risks,LC is safe and feasible for over 80 years old patients,provided that sufficient preoperative preparation,correct intraoperative and postoperative treatment are guaranteed.

关 键 词：胆囊切除术 腹腔镜 高龄患者 围手术期处理 

分 类 号：R657.4[医药卫生—外科学]