老年急性胆囊炎治疗方式选择及临床分析  

TREATMENT SELECTION AND CLINICAL ANALYSIS OF AGED PATIENTS WITH ACUTE CHOLECYSTITIS

作　　者：范江河[1] 付泽娴[1] 张华英[1] 王耀辉[1] 范天凤[1] 宋利华[1] 

机构地区：[1]河北工程大学附属医院急诊科,河北邯郸056029

出　　处：《河北医科大学学报》2013年第4期410-412,共3页Journal of Hebei Medical University

摘　　要：目的探讨老年胆囊炎治疗时机及治疗方式的选择,分析老年急性胆囊炎临床综合治疗的临床意义。方法选取2009年9月—2011年8月老年急性胆囊炎患者80例,随机分为试验组和对照组,试验组在超声引导下经皮经肝胆囊穿刺置管引流术,对照组常规行胆囊造瘘术。结果试验组在住院时间、住院费用、术后恢复时间、置管时间及手术操作时间上明显优于对照组,其治愈率明显高于对照组,减少了二次手术及相关并发症的发生;对于行二次手术的患者,试验组可行腹腔镜手术,其恢复时间及相关并发症的发生率均短于或低于对照组。结论老年胆囊炎患者起病急、进展快、病情复杂,早期利用经皮经肝胆囊穿刺置管引流术置管代替胆囊造瘘术,可尽快解除胆囊梗阻、减低胆囊压力、控制炎症发生,能增加治愈率、减少术后并发症和病死率。： Objective To explore the timing and the selection of treatment for the aged patients with acute cholecystitis, and to analyze the clinical significance of the comprehensive treatment to those patients. Methods Eighty aged patients with acute cholecystitis selected from September 2009 to August 2011 were randomly divided into the experimental group who received pereutaneous transhepatic gallbladder catheterizing drainage （PTGCD） and the control group who received cholecystostomy. Results The experimental group was significantly better than the control group in the hospitalization time, hospitalization cost, postoperative recovery time and the operation time. The cure rate of the experimental group was significantly higher than the control group. The PTGCD could reduce the chance of a second operation and related complications. For those who need a second operation in the experimental group, the laparoscopie surgery could be used, the recovery time and related complications were better than those in the control group. Conclusion The aged patients with acute cholecystitis were characterized by acute onset, fast progress and complex conditions. Early application of PTGCD could relief obstruction, reduce the gallbladder pressure and control the development of the inflammation. PTGCD could increase the cure rate, reduce postoperative complications and death of the aged patients with acute cholecystitis.

关 键 词：胆囊炎 急性 引流术 老年人 

分 类 号：R657.41[医药卫生—外科学]