老年肝内外胆管结石多次手术患者临床特征及生活质量分析  

Clinical characteristics and quality of life in elderly patients undergoing multiple surgeries for intrahepatic and extrahepatic bile duct stones

作　　者：徐向红 段艳伟[1] 纪淑青 Xu Xianghong;Duan Yanwei;Ji Shuqing(Department of Hepatobiliary,Pancreatic Splenic Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100043,China)

机构地区：[1]首都医科大学附属北京朝阳医院肝胆胰脾外科,北京100043

出　　处：《中华老年多器官疾病杂志》2025年第2期109-113,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：国家自然科学基金(82174239);北京市科技计划项目(Z171100000417010)。

摘　　要：目的研究老年肝内外胆管结石多次手术患者临床特征及生活质量。方法将2019年1月至2022年1月首都医科大学附属北京朝阳医院收治的肝内外胆管结石多次手术患者纳为研究对象,根据年龄将其分为老年组(年龄≥60岁;n=64)与中年组(年龄45~60岁;n=66)。收集并分析两组患者一般人口学资料、既往胆道手术资料及本次手术资料,分析老年组发病患者临床特征。术后随访至2023年10月,采用简明健康状况量表(SF-36)对其术后生活质量进行调查,分析老年肝内外胆管结石多次手术患者术后生活质量现状。采用SPSS 19.0软件进行数据分析。根据数据类型,组间比较分别采用t检验、χ^(2)检验及秩和检验。结果老年组患者年龄高于中年组,合并2型糖尿病(T2DM)、高血压、呼吸系统疾病及冠心病者占比高于中年组,差异均有统计学意义(均P<0.05);两组既往胆道手术次数、首次手术原因及首次手术方式比较,差异均无统计学意义。两组本次手术原因均为结石残留或复发,老年组患者本次手术距上次手术时间长于中年组,临床出现上腹区疼痛及发热症状者占比低于中年组,肝外胆管结石者占比高于中年组,结石直径大于中年组,行联合术式治疗者比例高于中年组,手术时间及住院时间长于中年组,术中出血量及术后并发症发生率高于中年组,差异均有统计学意义(P<0.05)。两组患者术后6个月生活质量SF-36量表各维度及总得分均较术前上升,差异均有统计学意义(均P<0.05);中年组术后6个月躯体功能、躯体角色、一般健康状况及SF-36总得分均高于老年组,差异均有统计学意义(均P<0.05)。结论不同年龄段肝内外胆管结石多次手术者本次手术原因均为结石残留或复发,但老年组患者术前临床症状不明显,且老年患者基础性疾病更多,与上次手术之间的间隔时间更长,结石直径更大,手术方案更为复杂,应注重手Objective To study the clinical characteristics and quality of life in elderly patients undergoing multiple surgeries for intrahepatic and extrahepatic bile duct stones.Methods Patients with multiple surgeries for intrahepatic and extrahepatic bile duct stones in Beijing Chaoyang Hospital of Capital Medical University from January 2019 to January 2022 were included as the study subjects.According to age,they were divided into an elderly group(age≥60 years;n=64)and a middle-aged group(aged 45-60 years;n=66).The general demographic data,data of previous biliary tract surgery,and data of the current surgery were collected and analyzed in both groups,and the clinical characteristics of the elderly group were analyzed.The patients were followed up after surgery until October 2023.The postoperative quality of life was investigated in elderly patients undergoing multiple surgeries for intrahepatic and extrahepatic bile duct stones using the 36-item short-form health survey(SF-36).SPSS statistics 19.0 was used for statistical analysis.Data comparison between two groups was perfomed using t test,χ^(2) test or rank-sum test depending on data type.Results The age in the elderly group was older than in the middle-aged group,the proportions of patients with type 2 diabetes mellitus(T2DM),hypertension,respiratory system diseases and coronary heart disease in the elderly group were higher than those in the middle-aged group,and the differences were statistically significant(P<0.05 for all).There were no statistically significant differences in the number of previous biliary tract surgeries,the reason for the first surgery and the method of the first surgery between the two groups.The reasons for the current surgery in the two groups were stone residual or recurrent stones.The interval between the last surgery and the current surgery was longer in the elderly group than in the middle-aged group.The proportions of patients with clinical upper abdominal pain and fever were lower,while the proportion of patients with extrahepati

关 键 词：老年人 肝内外胆管结石 多次手术 临床特征 术后生活质量 

分 类 号：R653[医药卫生—外科学] R592[医药卫生—临床医学]