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论著:老年急性非结石性胆囊炎患者的诊断与治疗
Diagnosis and Treatment of Acute Acalculous Cholecystitis in Elderly Patients
吴伟新 童赛雄 沈卫星 崔恒官
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作者单位:复旦大学附属中山医院青浦分院普外科
中文关键字:非结石性胆囊炎;手术时间;诊断
英文关键字:Acalculous cholecystitis; Treatment; Therapy
中文摘要:目的:探讨老年人急性非结石性胆囊炎(acute acalculous cholecystitis,AAC)的临床特点、诊断与治疗对策。方法:回顾性分析我院2004年1月—2011年12月收治的54例老年急性非结石性胆囊炎患者的临床资料。所有患者均行开腹手术,其中46例患者行剖腹胆囊切除术,5例患者伴胆总管扩张者加行胆总管切开探查、T管引流术,8例患者行胆囊造瘘术。按手术距发病时间不同把患者分为两组,即≤48 h 组和>48 h 组,比较两组患者的手术并发症发生率、胆囊病理特征以及患者的预后。结果:54例患者中,49例痊愈,5例病死。≤48 h组胆囊化脓、胆囊坏疽、胆囊穿孔、并发症发生率及病死率均显著低于>48h组。
英文摘要:Objective: To investigate the clinical characteristics, diagnosis and treatment methods of acute acalculous cholecystitis(AAC) in elderly patients. Methods:A retrospective study was conducted in 54 patients with ACC who were admitted to our hospital from January 2004 to December 2011. All of the patients underwent abdominal operation. Cholecystectomy was performed in 46 patients, and 5 patients with common bile duct dilatation underwent cholecystectomy and exploration of common bile duct with T tube drainage, while 8 cases underwent cholecystostomy. According to the time between onset and operation they were divided into Group A ( < 48 hours) and Group B ( > 48 hours ). The incidence of operation complications, gallbladder pathological characteristics and prognosis were analyzed. Results: Among the 54 patients, 49 cases were cured and 5 cases were dead. The incidences of gallbladder suppuration, gallbladder gangrene, gallbladder perforation, complication and mortality were significantly lower in Group A than in Group B. Conclusions: Timely diagnosis is very important in elderly AAC patients. Once diagnosed, early operation should be done.
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