合并基础疾病的老年急性胆囊炎临床治疗分析

目的：探讨合并基础疾病的老年急性胆囊炎特点及手术时机、手术方式。方法57例老年急性胆囊炎患者中发病72 h内手术（38例）设为早期手术组，72 h后手术（19例）设为延期手术组，比较两组手术时间、胆囊周围粘连情况、术中出血量、术后并发症等。结果全组患者治愈54例（94.74%），并发症5例（8.77%），以肺部感染、切口感染为主，早期组手术时间、术中出血量、周围粘连比延期组低，无死亡病例。结论老年急性胆囊炎患者病情进展快、合并病多，为有效降低死亡率，应在诊断明确后、尚未出现严重并发症前尽可能行早期手术治疗。

Analysis of clinical treatment for acute cholecystitis with primary diseases in aged patients

Objective To discuss clinical characteristics, operation opportunity and surgical methods of acute cholecys-titis with primary diseases in aged patients. Methods Fifty-seven aged patients with acute cholecystitis in combination with primary diseases were divided into early operation group and delayed operation group;the former （n=38） was defined as operation within 72 hours from onset while the latter （n=19）was defined as operation after 72 hours from onset. The operation time, pericholecystic adhesions, blood loss during operation and postoperative complications were compared between two groups. Results The cute rate of 57 patients was 94.74%（54/57）, complication rate was 8.77%（5/57）, mainly lung infection and wound infection. The operation time, blood loss during operation and pericholecystic adhesions in early operation group were significantly lower than in delayed group. No deaths occurred. Conclusion Acute cholecys-titis with primary diseases in aged patients develop rapidly with more complications, it is indispensible to perform surgery before serious complications with the aim of decreasing mortality.