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1、老年患者腹腔镜胆囊切除术320例临床分析作者：黄擂,李克军，程，雷，罗海峰,王洪江，谭单位：大连医科大学附属第一医院，辽宁大连【摘要】目的：评价老年人行腹腔镜胆囊切除术(laparoscopiccholecystectomy,LC)的安全性及可行性，探讨防范风险的应对措施。方法：比较、分析60岁以上老年人LC组(n=320)、开腹胆囊切除术(opencholecystectomy,0C)组(n=l12)及非老年LC组(n=l923)的临床资料。结果：老年人LC及0C组并存病显著高于非老年LCai(P<0.001)oLC组患者术后恢复息好，未发生严重并发症
2、;老年LC与非老年LC在平均手术时间、平均术后住院天数及中转开腹率方面差异无统计学意义(P>0.05);
3、flJOC组平均手术时间、平均术后住院天数均较LC组显著延长(P<0.001),且并发症多(P<0.05)。结论：只要高度重视围手术期的处理，正确评估麻醉与手术的风险，把握手术时机及技巧，对老年患者施行LC不仅安全可行，而且更能凸显微创手术的优越性。【关键词】胆囊切除术，腹腔镜;老年人;病例报告Theclinicalanalysisoflaparoscopiccholecystectomyinelderlypatients:areport
4、of320casesDONGLei,LIKejun,CHENGLei,etaLTheFirstAffiliatedHospitalofDalianMedicalUniversity,Dalian116024,China[Abstract]Objective:Toevaluatethesafetyandfeasibilityoflaparoscopiccholecystectomy(LC)inelderlypatients.andexplorethemeasurestopreventrisk.Methods:Theclinicaldataofthepatient
5、solderthan60treatedbyLC(n=320)andopencholecystectomy(OC.n=112)wereanalyzedretrospectivelyandcomparedwiththoseofotheradultpatients(n=l923)underwentLCatthesamestage.Results:Theratewithotherdiseaseswassignificantlyhigherintheelderlygroupsthanthatofotheradultgroup(P<0.001).Thepatient
6、streatedbyLCinbothgroupsrecoveredsmoothly,withoutseriouscomplications.Therewerenosignificantdifferencesonthemeanoperatingtime,averagepostoperativehospitalization,aswellastherateofconversionbetweenthetwoLCgroups(P>0.05).Butitwasfoundthatthemeanoperatingtimeandaveragepostoperativeh
7、ospitalizationinLCgroupsweresignificantlylonger(P<0.001),andpostoperativecomplicationsweremorethanthoseofOCgroup(P<0.05).Conclusions:Onlyifgreatimportancewasattachedtoperioperativemanagement,theanaesthesiaandsurgicalriskswereestimatedcorrectly,andthetimingandtechniquesofoperat
8、ionwascontrolledperfectly,LCwillbesateandminimallyinvasiveforelderlypatients.[Keywords]Cholecystectomy,laparoscopic;Aged;Casereport老年人常合并其他系统疾病，尤其是心肺疾病，对气腹耐受性差，手术风险高，为评价老年患者行腹腔镜手术的安全性，现回顾分析2000年4月至2008年5月我院收治的320例大于60岁胆囊良性疾病患者行腹腔镜胆囊切除术(laparoscopiccholecystectomy,LC)的临床资料，并将结果报道如下。1
9、资料与方法1.1临床资料2000年4月
