叶荣强+谢元才++钟鼎文

[摘要]目的 探讨老年胆结石手术治疗方法和效果。方法 选取2013年2月～2015年9月我院收治的老年胆结石患者100例，根据手术方式的不同分为腔镜手术组和常规手术组。常规手术组采用传统胆囊切除手术进行治疗，腔镜手术组采用腹腔镜胆囊切除手术进行治疗。比较两组患者胆囊切除手术时间、术中出血量、术后肛门排气时间、住院天数和治愈率、并发症发生率及术后生存质量。结果 腔镜手术组治愈率与常规手术组相似（P>0.05）；腔镜手术组并发症发生率低于常规手术组（P<0.01）；腔镜手术组患者胆囊切除手术时间与常规手术组比较，差异无统计学意义（P>0.05）；腔镜手术组患者术中出血量、术后肛门排气时间、住院天数均少于常规手术组（P<0.01）；腔镜手术组患者术后生存质量明显优于常规手术组（P<0.05）。结论 老年胆结石采用腹腔镜胆囊切除手术进行治疗效果确切，可有效减少手术创伤，减少术中出血和术后并发症的发生，加速术后肛门排气，缩短住院时间，促进手术后患者生存质量的提高，值得推广。

[关键词]老年胆结石；腹腔镜胆囊切除术；排气时间；生存质量

[中图分类号] R575.6+2 [文献标识码] A [文章编号] 1674-4721（2016）09（b）-0019-03

[Abstract]Objective To explore the method and effect of the treatment of senile patients with gallstones.Methods Sources of information in our hospital from February 2013 to September 2015，100 cases of cholelithiasis were treated，according to the different surgical methods，divided into endoscopic surgery group and conventional surgery group.Conventional surgery group was used traditional gallbladder resection surgery treatment；endoscopic surgery group was used laparoscopic gallbladder resection surgery treatment.In the two groups of patients with cholecystectomy operation time，bleeding volume，postoperative anal exhaust time，hospital days and the cure rate，the incidence of complications，postoperative quality of life were compared.Results The cure rate of laparoscopic surgery group was similar to conventional surgery group（P>0.05），complication rate of laparoscopic surgery group was lower than that of conventional surgery group（P<0.01）.Laparoscopic surgery group patients with cholecystectomy with conventional surgery group had no significant difference（P>0.05）.Laparoscopic surgery group of intraoperative bleeding，postoperative anal exhaust time，hospitalization time were less than those of conventional surgery group（P<0.01）.The quality was superior to conventional laparoscopic surgery group survival surgery group（P<0.05）.Conclusion Cholelithiasis by laparoscopic surgery for treatment，can effectively reduce the surgical trauma，reduce the intraoperative bleeding and postoperative complications after，accelerate postoperative anal exhaust，shorten the hospitalization time，improve the quality of life in patients with postoperative，worthy of promotion.

[Key words]Elderly patients with gallstones；Laparoscopic cholecystectomy；Exhaust time；Quality of life

胆结石为常见消化系统疾病，常需进行手术治疗。目前，随着人们生活质量的不断提高，我国人均寿命也不断升高，高龄人群越来越多，而高龄人群胆结石发病率也随之升高。因老年人机体功能降低，在临床诊断过程容易出现误诊和漏诊，导致患者错失最佳治疗时机，还可引发心脑血管等并发症[1-3]，如胆结石合并冠心病等。临床治疗胆结石的手术方式常见的包括常规外科手术和腹腔镜手术[4]，本研究探讨了老年胆结石手术治疗方法和效果，现报道如下。

1 资料与方法

1.1 一般资料

选取2013年2月～2015年9月我院收治的老年胆结石患者100例，根据手术方式的不同分为腔镜手术组和常规手术组，各50例。所……