70岁以上老年重症胆管疾病治疗分析(附38例报告)

目的探讨70岁以上老年急性胆囊炎胆石症并发坏疽性胆囊炎、胆囊穿孔腹膜炎、急性化脓性胆管炎（ASC）的特点和治疗措施,以降低病死率。方法2001～2005年收治急性重症胆管患者38例,年龄71～86岁,平均76.4岁。伴高血压、冠心病、糖尿病及慢性支气管炎肺气肿等疾病。入院给予上腹彩超、心电图、血常规、凝血功能、血气分析、血生化检查。入院6～24h行急症手术31例,保守治疗3～5d后中转手术7例。结果急症手术组死亡1例,中转手术组死亡2例,两组病死率间差异有显著性意义（P〈0.05）。余35例均痊愈出院。结论老年人重症胆管急症具有急症手术可行性和临床意义。

Clinical Analysis of Surgical Diagnosis and Treatment on 38 Cases with Severe Biliary Tract Diseases in the Elderly Over Seventy Years Old

Objective To investigate the diagnosis and treatment of complications in patients over than 70 with acute cholecystitis/cholelithiasis.Methods 38 cases between 2001 to 2005 were retrospectively studied.31cases were performed emergency procedure within 6~24 h after hospital admissions,7 were transferred to the operation after 3~5 days' conservative treatment.Results 1 case died in the emergency operation group.Two died in the transferring operation group,There was statistical significance of the mortality between the two groups(P<0.05).The rest recovered and discharged from hospital.Conclusion It is feasibile of performing emergency procedure in elderly patients with severe acute biliary tract diseases.