摘要
目的探讨老年人急性非结石性胆囊炎(acute acalculous cholecystitis,AAC)的最佳手术时机。方法回顾性分析20年来45例老年人 AAC 不同手术时机的的胆囊理改变及手术后并发症和死亡情况。结果老年人 AAC 约60%合并有糖尿病、心血管疾病及慢性阻塞性肺疾患。从 AAC 症状出现至实施手术的平均间隔时间为46.8±2.5小时,与同期老年人急性结石性胆囊炎(acute calculous cholecystitis,ACC)相比,老年人 AAC 的胆囊坏疽穿孔率明显增高(P<0.01)。老年人 AAC 症状出现48小时内手术者较超过48小时手术者术后并发症和病死率明显减少(P<0.01)。结论老年人 AAC 宜在症状出现48小时内实施手术治疗。
Objective To evaluate the optimal timing of operation for acute acalculous cholecystitis(AAC)in the aged.Methods A retrospective analysis of 45 cases of AAC in the elderly patients was made.Results Most aged patients with AAC had coexisting cardiovascular and metabolic diseases;the mean interval from onset of symptoms to operation was 46.8±2.5 hours.Compared with acute calculous cholecystitis (ACC) in the elderly, gallbladder perforation and gangrene develop more frequently(P<0.01)in AAC;The postoperative complica- tion and mortality decreased significantly when the operation was performed within 48 hours of onset(P< 0.01).Conclusion Surgery should be performed within 48 hours of onset of symptoms of AAC for the safety in the elderly patients.
出处
《中华普通外科杂志》
CSCD
1998年第3期155-157,共3页
Chinese Journal of General Surgery
