老年胆囊穿孔外科治疗27例分析

目的 分析老年胆囊穿孔诊治特点,提高围手术期处理经验.方法 对我院普外科2000年1月至2006年12月间共收治老年急性胆囊穿孔27例临床资料进行回顾性分析.结果 本组27例病例中,有慢性囊炎或胆囊结石病史25例,并存内科疾病19例(70.04%),术后并发症11例(40.74%),1例因多器官功能衰竭死亡.结论 由于老年人的生理及病理特点,其胆囊穿孔临床表现不典型,加之内科合并症较多见,术后并发症发生率高.应选择合适的手术时机、麻醉和手术方式,并加强围手术期处理.

Surgical treatment for gallbladder perforation in the elderly

Objective To investigate the surgical treatment for gallbladder perforation in the elderly and to improve therapeutic results.Methods Data of 27 elderly patients with acute gallbladder perforation treated between January 2000 and December 2006 were retrospectively analysed.Results Of the 27 patients, 25 patients had a medical history of chronic cholecystitis or cholecystolithiasis, 19 patients (70.04%) had coexisting medical conditions. Complications were observed in 11 patients (40.74%) after operation, one patient died from multiple organs failure.Conclusion Because of the pathophysiological characteristics of the elderly patients, the clinical presentations of gallbladder perforation are atypical, coexisting medical conditions and postoperative complications are common. Special attention should be paid to the timing for operation, anesthetic methods, operative methods and perioperative nursing care.