最新精编医学专题—肝胆外科相关文章-(5).docx

老年患者腹腔镜胆囊切除术320例临床分析作者：董擂李克军程雷罗海峰王洪江谭广王忠裕作者单位：大连医科大学附属第一医院辽宁大连116024【摘要】目的：评价老年人行腹腔镜胆囊切除术(laparoscopiccholecystectomyLC)的安全性及可行性探讨防范风险的应对措施。方法：比较、分析60岁以上老年人LC组(n=320)、开腹胆囊切除术(opencholecystectomyOC)组(n=112)及非老年LC组(n=1923)的临床资料。结果：老年人LC及OC组并存病显著高于非老年LC组(P<0.001)。LC组患者术后恢复良好未发生严重并发症;老年LC与非老年LC在平均手术时间、平均术后住院天数及中转开腹率方面差异无统计学意义(P>0.05);而OC组平均手术时间、平均术后住院天数均较LC组显著延长(P<0.001)且并发症多(P<0.05)。结论：只要高度重视围手术期的处理正确评估麻醉与手术的风险把握手术时机及技巧对老年患者施行LC不仅安全可行而且更能凸显微创手术的优越性。【关键词】胆囊切除术腹腔镜;老年人;病例报告Theclinicalanalysisoflaparoscopiccholecystectomyinelderlypatients:areportof320casesDONGLeiLIKejunCHENGLeietal.TheFirstAffiliatedHospitalofDalianMedicalUniversityDalian116024China【Abstract】Objective:Toevaluatethesafetyandfeasibilityoflaparoscopiccholecystectomy(LC)inelderlypatientsandexplorethemeasurestopreventrisk.Methods:Theclinicaldataofthepatientsolderthan60treatedbyLC(n=320)andopencholecystectomy(OCn=112)wereanalyzedretrospectivelyandcomparedwiththoseofotheradultpatients(n=1923)underwentLCatthesamestage.Results:Theratewithotherdiseaseswassignificantlyhigherintheelderlygroupsthanthatofotheradultgroup(P<0.001).ThepatientstreatedbyLCinbothgroupsrecoveredsmoothlywithoutseriouscomplications.TherewerenosignificantdifferencesonthemeanoperatingtimeaveragepostoperativehospitalizationaswellastherateofconversionbetweenthetwoLCgroups(P>0.05).ButitwasfoundthatthemeanoperatingtimeandaveragepostoperativehospitalizationinLCgroupsweresignificantlylonger(P<0.001)andpostoperativecomplicationsweremorethanthoseofOCgroup(P<0.05).Conclusions:OnlyifgreatimportancewasattachedtoperioperativemanagementtheanaesthesiaandsurgicalriskswereestimatedcorrectlyandthetimingandtechniquesofoperationwascontrolledperfectlyLCwillbesafeandminimallyinvasiveforelderlypatients.【Keywords】Cholecystectomylaparoscopic;Aged;Case