老年患者腹腔镜胆囊切除术的围术期处理(1)
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2010年4月15日
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[摘要] 目的:探讨老年患者腹腔镜胆囊切除术(LC)的安全性及围术期的处理。方法:回顾性比较、分析老年患者胆囊疾病腹腔镜胆囊切除术(LC)组及开腹胆囊切除术(OC)组的临床资料,其中并存疾病为心血管系统疾病、呼吸系统疾病、糖尿病、慢性肾功能不全、慢性肝病肝硬化等。结果:OC组平均术后住院天数、自主下床活动时间、肠功能恢复时间较LC组显著延长,差异有统计学意义(P<0.01),而平均手术时间、术后腹腔引流量两组比较,差异无统计学意义(均P>0.05)。结论:老年胆囊疾病患者在术前重视并存疾病的治疗、术中及术后监测的基础上,LC更能显示其创伤小、恢复快的优越性,是安全可靠的手术方法。
[关键词] 老年患者;腹腔镜胆囊切除术;围术期
[中图分类号] R575.6 [文献标识码]A [文章编号]1674-4721(2010)04(b)-035-02
Perioperative management in laparoscopic cholecystectomy for the elderly
DING Yanbin1,FU Xiaoguang2
(1.Department of General Surgery, Chaoyang Hospital,Chaoyang122000, China;2.General Surgery of the First Affiliated Hospital of Liaoning Medical College, Jinzhou121000, China)
[Abstract] Objective: To investigate the safety and perioperative period managements in elderly patients who underwent laparoscopic cholecystectomy(LC). Methods: The clinical data of elderly patients with cholecystitis treated by laparoscopic cholecystectomy were retrospectively analyzed and compared with that of patients treated by open cholecystectomy(OC).Most of the patients were concomitant with high risk factors, such as poor cardiopulmonary function, respiratory diseases,severe diabetes mellitus,chronic hepatic cirrhosis or renal dysfunction. Results: The patients treated by OC had longer postoperative recovery, resumed normal intestinal peristalsis slower and were discharged from hospital later, which had significantly stastical difference(P<0.01). But there was no significant different in the mean time and the quantity of flowing liquid from abdominal cavity after operation between the two groups (P<0.05). Conclusion: LC is safe and feasible for elderly patients with gallbladder diseases. Preoperative evaluation of concomitant disease, intra-operative and post operative monitoring have allowed LC to reveal its advantage in micro-injury and quickly recovery.
[Key words] Elderly patients;Laparoscopic cholecystectomy;Perioperative period
随着社会老龄人口的增加,高龄胆囊疾病的发病率与胆囊切除术比例相对增多,由于老年人生理功能下降,许多器官都存在潜在的功能不全,常并存其他老年性疾病,开腹手术,无疑将对其全身造成更大创伤 ......
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