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目的探讨老年急性化脓性胆囊炎患者的手术时机和术式选择。方法回顾性分析在肥西县人民医院治疗的65例老年急性化脓性胆囊炎患者临床资料,根据发病72 h内手术和72 h后手术分为早期组(n=34)和延期组(n=31),对比手术疗效。同时比较不同手术方式对治疗效果的影响。结果延期组患者的平均手术时间为(67.36±6.32)min,平均总住院(14.37±2.43)d,两项均长于早期组患者,差异有统计学意义。但两组在手术治疗效果和并发症的发生情况等方面相比差异无统计学意义。胆囊切除术为首选术式,预后较胆囊大部切除术和胆囊造口术好。结论对于老年急性化脓性胆囊炎,发病超过72 h并非手术禁忌期。选择合适的手术时机和术式,熟练手术技术,避免周围组织损伤,防止并发症是提高预后的关键。
Objective To investigate the timing of operation and the choice of surgical procedure in elderly patients with acute suppurative cholecystitis. Methods The clinical data of 65 elderly patients with acute suppurative cholecystitis treated in Feixi People’s Hospital were retrospectively analyzed. According to the operation within 72 h and the operation after 72 h, the patients were divided into early stage (n = 34) and delayed stage (n = 31), compared with surgical treatment. At the same time compare the effect of different surgical methods on the treatment effect. Results The average operation time of patients in deferred group was (67.36 ± 6.32) min and average hospitalization was (14.37 ± 2.43) days, both of which were longer than those in early group. The difference was statistically significant. However, there was no significant difference between the two groups in the surgical treatment effect and the incidence of complications. Cholecystectomy as the preferred surgical procedure, the prognosis is better than the Gallbladder and gallbladder ostomy. Conclusion For the elderly acute suppurative cholecystitis, the onset of more than 72 h is not a taboo surgery. Select the appropriate timing and operation of surgery, skilled surgical techniques to avoid the surrounding tissue damage and prevent complications is the key to improving the prognosis.