赵雄齐 高红强 白建华 秦勇

[摘要] 目的 探讨分析老年胆囊结石患者采用腹腔镜胆囊切除术治疗的临床效果。 方法 选择2013年1月～2017年5月间我院经治的47例老年胆囊结石患者为实验组，所有患者均行腹腔镜胆囊切除术治疗。另选取同时期来我院行传统切除术的老年胆囊结石患者作为对照组，观察老年胆囊结石患者的临床治疗效果。针对其住院时间、手术时间、术中出血量、住院费用、切口长度、临床治疗有效率、并发症情况、手术前后的炎症因子及免疫功能情况进行分析。 结果 经治疗，实验组老年胆囊结石患者的治疗有效率为93.62%，患者的住院时间为（2.8±0.4）d、手术时间（42.6±13.5）min、术中出血量（26.1±9.7）mL、住院费用（3264±274）元及切口长度（3.2±0.6），均优于对照组（P<0.05）。实验组发生并发症者3例，明显少于对照组的8例，两组比较差异有统计学意义（P<0.05）。结论 腹腔镜胆囊切除术治疗对于老年胆囊结石患者是非常有效的治疗手段，可提高患者的治疗有效率，有利于患者的康复。

[关键词] 老年胆囊结石；腹腔镜治疗；胆囊切除术；炎症因子

[中图分类号] R657.4+1 [文献标识码] B [文章编号] 1673-9701（2018）02-0037-03

[Abstract] Objective To investigate the clinical effect of laparoscopic cholecystectomy in elderly patients with cholecystolithiasis. Methods 47 elderly patients with cholecystolithiasis treated in our hospital were selected as the experimental group. The data of the patients were from January 2013 to May 2017， and all the patients underwent laparoscopic cholecystectomy. In addition， the elderly patients with cholecystolithiasis who underwent traditional cholecystectomy in the same period were selected as the control group. The hospitalization time， operation time， intraoperative bleeding， hospitalization costs， incision length， clinical treatment efficiency， complications， Inflammatory factors before and after surgery and immune function were analyzed. Results The effective rate of treatment was 93.62% in patients with elderly cholecystolithiasis after treatment. The length of hospital stay（2.8±0.4） d， the operation time（42.6±13.5）min， the amount of bleeding during operation（26.1±9.7）mL， hospitalization costs （3264±274）yuan and length of incision（3.2±0.6）in the experimental group were all better than those in the control group（P<0.05）. There were 3 cases of complication in the experimental group， which was significantly fewer than 8 cases in the control group， and the difference was statistically significant（P<0.05）. Conclusion Laparoscopic cholecystectomy is a very effective treatment for elderly patients with cholecystolithiasis， which can improve the treatment efficiency of patients and facilitate the recovery of patients.

[Key words] Elderly cholecystolithiasis；Laparoscopic treatment；Cholecystectomy；Inflammatory factors

近年来，随着人们生活水平的不断提高，人们的生活方式也發生很大的变化，一些疾病的发病率也逐渐升高，如胆囊结石[1]。其中老年胆囊结石会随着年龄的增大而升高[2]。根据权威数据显示，目前胆囊结石在我国每年的发病率高达8%，临床上的患者通常会表现为严重的右上腹痛，有的患者会伴有局部的腹膜刺激征，严重干扰患者的正常生活，降低患者的生活质量[3-4]。目前，临床上主要对患者采取手术治疗，不同的手术治疗方式对患者的影响不同。本研究为进一步分析腹腔镜胆囊切除术的效果，选择经我院治疗的47例老年胆囊结石患者，现报道如下。……