老年人急性非结石性胆囊炎坏疽穿孔18例临床分析

目的总结老年人非结石性胆囊炎坏疽、穿孔的特点和诊疗经验,提高诊断率及治愈率。方法对我院2000年1月至2005年12月收治的老年人非结石性胆囊炎坏疽、穿孔18例临床资料进行回顾性分析。结果18例患者均行手术治疗,其中开腹手术15例,应用腹腔镜3例。治愈15例(83.3%),死亡3例(16.7%)。结论老年人由于全身重要脏器机能储备及其代偿能力降低,应激能力减退,常伴有各种疾病,临床表现复杂,病情发展迅速,胆囊坏疽、穿孔的发生率高。手术时机把握最为重要,早期手术是关键。

Clinical analysis of gangrene and perforation in aged patients with acute acalculous cholecystitis:a report of 18 cases

Objective To study the characteristic of gangrene and perforation in aged people with acute acalculous cholecystitis and experience of diagnosis and treatment.Methods Eighteen cases of gangrene and perforation in aged people with acute acalculous cholecystitis in our hospital between January,2000 and December,2005 were reviewed retrospectively.Results Of the 18 patients subject to surgical operation,15 cases received laparotomy and 3 received laparoscopic surgery.Fifteen cases((83.3%))were cured and 3 cases(13.7%) were dead.Conclusion Due to the capability of reservation and compensation of significant organs in aged people depressing and faculty of stress decreasing,their clinical manifestation is multiple,and the progression of disease is fast.Incidence of gangrene and perforation is high.It is vital to grasp the operative timing and it is a key to perform operation early.