| 李殿启,李健,赵晓光,等.腹腔镜胆囊切除术治疗老年肥胖急性结石性胆囊炎的疗效和安全性分析[J].安徽医药,2018,22(11):2159-2161. |
| 腹腔镜胆囊切除术治疗老年肥胖急性结石性胆囊炎的疗效和安全性分析 |
| Curative effect and safety analysis of laparoscopic cholecystectomy for treating acute calculous cholecystitis in obese elderly patients |
| 投稿时间：2017-02-04 |
| DOI： |
| 中文关键词: 急性结石性胆囊炎 胆囊切除术 腹腔镜 老年医学 肥胖 |
| 英文关键词: Acute calculous cholecystitis Cholecystectomy Laparoscopy Geriatrics Obesity |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨老年肥胖急性结石性胆囊炎(ACC)患者行腹腔镜胆囊切除术(LC)的疗效和安全性。方法 对中国人民解放军第四一三医院2008年1月至2016年6月收治的126例老年肥胖ACC患者进行回顾性分析,患者被分成两组:腹腔镜手术组77例和传统开腹手术组49例。比较两组患者的部分血液检测指标和手术相关资料及并发症发生情况。结果 腹腔镜组和开腹组术后第3天C-反应蛋白分别为(34.5±16.4)mg·L-1和(42.8±17.9)mg·L-1,丙氨酰氨基转移酶分别为(51.3±12.6)U·L-1和(58.2±12.9)U·L-1,差异有统计学意义(P<0.05)；腹腔镜组手术时间长[(48.8±9.7)min],但是术中出血少[(21.3±7.2)mL],术后肛门排气快[(23.6±6.9)h],疼痛程度轻[(3.0±0.9)分],住院时间短[(5.1±1.8)d]；腹腔镜组脂肪液化和感染发生1例,胸腔积液和肺部感染发生3例,发生率均低于开腹组(5例和7例),差异有统计学意义(P<0.05)。结论 LC创伤小、恢复快、并发症少,可作为腹腔镜技术经验丰富的医师治疗老年肥胖ACC的首选手术方法。 |
| 英文摘要: |
| Objective To explore the curative effect and safety analysis of laparoscopic cholecystectomy for treating acute calculous cholecystitis in obese elderly patients.Methods One hundred and twenty-six obese elderly patients with acute calculous cholecystitis undergoing surgical treatment in No.413 Hospital of PLA from January 2008 to June 2016 were analyzed retrospectively.The patients were assigned into two groups:77 cases were treated with laparoscopic approach as laparoscopic surgery group and 49 were treated with open surgery as open surgery group.Blood test results,operation related data and complications between the two groups were compared.Results Postoperative 3-day C-reaction protein levels in the two groups were (34.5±16.4) mg·L-1 and (42.8±17.9) mg·L-1,respectively;alanine aminotransferase levels were (51.3±12.6) U·L-1 and (58.2±12.9) U·L-1,and the differences were statistically significant (P<0.05).Patients in the laparascopic group underwent longer surgery time (48.8±9.7) min,but had less intraoperative hemorrhage (21.3±7.2)mL,less time before passing gas (23.6±6.9) h,lower postoperative pain scores (3.0±0.9) points,and shorter length of hospital stay (5.1±1.8) d.One case of fat liquefaction and infection and 3 cases of pleural effusion and pulmonary infection occurred in laparoscopic group,which was lower than those in open surgery group (5 cases and 7 cases,respectively),and the difference was statistically significant (P<0.05).Conclusion Laparoscopic cholecystectomy has less trauma,faster recovery and less complications.It could be the first choice of treating acute calculous cholecystitis in obese elderly patients. |
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