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目的:探讨老年人急性坏疽性胆囊炎的诊断及中西医结合治疗,以减少并发症,降低死亡率。方法:对81例老年人急性坏疽性胆囊炎的临床资料进行回顾性分析。结果:81例均经腹腔镜手术治疗,其中腹腔镜胆囊切除术67例,腹腔镜胆囊造瘘术10例,中转开腹4例。术中探查及术后病理证实胆囊均为坏疽,术中探查5例患者发生穿孔。术后患者均给予中医辨证治疗,所有病例均得到治愈,81例中出现术后并发症1例(1.2%)为切口感染,经换药治疗治愈。结论:对老年急性坏疽性胆囊炎早诊断、早手术,积极处理并存病,并予以腹腔镜手术及术后中医辨证治疗能明显减少并发症的发生并降低死亡率。
Objective: To investigate the diagnosis of acute gangrenous cholecystitis in the elderly and the combination of traditional Chinese and western medicine in order to reduce complications and reduce mortality. Methods: The clinical data of 81 elderly patients with acute gangrenous cholecystitis were analyzed retrospectively. Results: All of the 81 cases were treated by laparoscopic surgery, including 67 cases of laparoscopic cholecystectomy, 10 cases of laparoscopic cholecystectomy and 4 cases of laparoscopic cholecystectomy. Intraoperative exploration and postoperative pathology confirmed that the gallbladder were gangrene, intraoperative exploration of 5 patients with perforation. Postoperative patients were given TCM syndrome differentiation, all cases were cured, 81 cases of postoperative complications occurred in 1 case (1.2%) incision infection, cured by dressing change. Conclusion: Early diagnosis and early operation of acute gangrenous cholecystitis in elderly patients and active treatment of concurrent disease, and laparoscopic surgery and postoperative TCM syndrome differentiation treatment can significantly reduce the incidence of complications and reduce mortality.