105例老年急性胆道感染患者的外科治疗  

Surgical treatment for 105 elderly patients with acute biliary tract infection

作　　者：叶诚清[1] 陈松[1] 谢凯[1] 

机构地区：[1]福清市医院普通外科,福建福清350300

出　　处：《局解手术学杂志》2013年第3期278-279,共2页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨老年急性胆道感染患者急诊外科治疗方法及疗效。方法回顾性分析2001年1月至2011年12月我院105例因急性胆道感染进行急诊手术老年患者的临床资料,其中男42例,女63例,年龄70～86岁。单纯急性胆囊炎、胆囊结石46例,合并胆管结石梗阻性胆管炎59例,有手术史或合并症的74例。入院后24 h内手术者24例,入院后经24～72 h保守治疗无效后改为急诊手术者81例。结果全部患者均选择使用头孢类、喹诺酮类、氨基糖苷类和甲硝唑等抗生素抗感染,同时加强对原发基础病及并发症的治疗。105例中72例(68.57%)治愈出院,术后并发症31例(29.52%),死亡2例(1.90%)。结论老年患者急性胆道感染病情发展快,并发症多,根据病情积极采用个体化治疗可以防止术后并发症和降低死亡率。Objective Retrospective analyze the emergency surgical treatment methods and the clinical significance of elderly acute biliary tract infection. Methods Collected 105 elderly patients with acute biliary tract infection who received emergency operation in our hospital from January 2001 to December 2011, including 42 male and 63 female patients aged 70 - 86 years old. 46 cases of them were of simple acute eholecystitis or gallstones, 59 cases were combined with bile duct obstructive cholangitis, and 74 cases have history of surgery or complications. There were 24 cases received operation within 24 hours after admission, and the other 81 cases were performed emergency operation after 24 - 72 hours invalid conservative treatment. Results Antibiotic resistance such as eephalosporins, quinolones, aminoglycoside and metronidazole were given to all the patients, and at the same time, enhance treatment were given to primary disease and complications. Among the 105 cases, 72 cases （68.57%） cured in the hospital, 31 patients （29.52%） had postoperative complications and 2 cases （ 1.90% ） died. Conclusion The results show that acute biliary infections is of fast disease progresses and many complications, and the treatment is difficult. Adopt individual therapy according to condition of patients which could reduce complications and mortality is the key to sucssess.

关 键 词：急性胆道感染 外科治疗 并发症 老年患者 

分 类 号：R657.4[医药卫生—外科学]