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1、合并基础疾病的老年急性胆囊炎患者胆囊切除术手术时机探讨张壳(钦州市屮医医院外一科广西钦州535099)【摘要】冃的：探讨不同胆囊切除术手术时机对合并基础疾病的老年急性胆囊炎患者临床效果的影响。方法:将89例合并基础疾病老年急性胆囊炎患者根据不同手术时间分为早期组(n=42,发病72h内手术)和晚期组(n=47,发病72h后手术)，均行腹腔镜胆囊切除术，比较两组患者的手术情况及术后恢复情况。结果：早期组组织粘连程度分布(30.95%、59.53%、7.14%、2.38%)显著优于晚期组(Z=2.062,PV0.05)；早期组住院时间(5.51±2
2、.13)d、住院费用(8271.9±1044.2)元均明显低于晚期组(t=-6.675>-6.866,P<0.05)；两组患者手术时间、术屮出血量、并发症发生率比较差异无统计学意义(P>0.05)o结论:对合并基础疾病的老年急性胆囊炎患者早期发病72h内行胆囊切除术手术有利于促进患者康复，减少了住院费用，值得临床重视。【关键词】急性胆囊炎；老年患者；基础疾病；胆囊切除术；手术时机【文献标识码】A【屮图分类号】R615【文章编号】2095-1752(2015)17-0237-02Discussionontheopportunityofcholec
3、ystectomyforelderlypatientswithacutecholecystitiscomplicatedwithbasicdiseasesZhangLiangDepartmentofgeneralsurgery,TheHospitaloftraditionalChineseMedicineofQinzhou,Qinzhou535099,China[Abstract]ObjectiveToinvestigatetheopportunityofcholecystectomyforelderlypatientswithacutecholecysti
4、tiscomplicatedwithbasicdiseases.Methods89caseswithbasicdiseasesinelderlypatientswithacutecholecystitisdividedaccordingtodifferentoperationtimefortheearlygroup(n=42,operationwithin72hoursafteronset)andlategroup(n=47,72hoursafteronsetofsymptomaftersurgery)underwentlaparoscopicgallbla
5、dderresection,thesurgeryandpostoperativerecoveryconditionwerecomparedbetweenthetwogroups.ResultsEarlytissueadhesiondegreedistribution(30.95%,59.53%,7.14%,2.38%)wassignificantlybetterthanthelategroup(Z=2.062,P<0.05);earlygroup,thehospitalizationtime(2.13±5.51)d,hospitaliza
6、tionexpenses(8271.9±1044.2)yuanweresignificantlylowerthanthelategroup(t=-6.675,-6.866,P<0.05);theoperativetime,amountofbleeding,complicationratediffereneewasnotstatisticallysignificant(P>0.05).ConelusionTheearlyonsetof72hintheelderlypatientswithacutecholecystitiswithba
7、sicdiseaseofthediseasecanpromotetherehabilitationofpatientsandreducethehospitalizationexpensesjtisworthyofclinicalattention.【Keywords］Acutecholecystitis;Elderlypatients;Basicdisease;Resectionofgallbladder;Operationopportunity急性胆囊炎是临床中的一种胆囊炎症，具有起病急、病情进展快等特点，以右上腹疼痛、发热、恶心呕吐为主要临床表现。急性胆
8、囊炎多伴有胆囊结石，而且老年患者往往合并慢性支气管炎
