【关键词】胆囊结石   腹腔镜胆囊切除术  老年人
【摘要】目的  探讨腹腔镜胆囊切除术(LC)在治疗老年胆囊结石中的临床价值和安全性。方法  回顾分析老年组178例围手术期的处理．包括对伴随疾病的诊治、术中风险、术后并发症和治愈率等，与同期非老年组356例临床资料作统计学分析。结果  老年组170例(95.5％)LC成功，8例中转开腹手术，18例术中心率失常，4O例术中出现血压升高或大幅度波动，3例术后引流管短暂胆汁漏，6例术后出现肺部感染。非老年组356例患者中346例(97.2%)LC成功，1O例中转开腹手术，15例术中心率失常，11例术中出现血压升高或大幅度波动，2例术后引流管短暂胆汁漏。两组病例均恢复好，无死亡。结论  虽然老年组LC术中风险和术后并发症相对较非老年组大，但做好围手术期处理，LC对老年人和中青年患者一样安全可行并能获得满意的疗效。
【中图分类号】R657.4【文献标识码】A【文章编号】1672-5085（2011）40-0021-03
【Abstract】 objective  To explore the Laparoscopic cholecystectomy (LC) in the treatment of gallstones in elderly clinical value and safety. Methods  Retrospective analysis of elderly patients 178 cases of perioperative treatment. Including diagnosis and treatment of diseases associated with, the risk of intraoperative and postoperative complications and cure rate, etc.,non-elderly group with the same period 356 cases of clinical data compared for statistical analysis.Results Age group 170 cases (95.5%) L C success，8cases of conversion to open surgery，18 cases of intraoperative heart rate disorders, 40 cases of intraoperative blood pressure, or fluctuations，3 patients short-term bile drainage tube leakage，6 cases had lung infection. Non-elderly group 356 patients in 346 cases (97.2%) LC success，1O cases were converted to open surgery，15 cases of intraoperative heart rate disorders, 11 cases of intraoperative blood pressure, or fluctuations，2 patients had transient bile drainage tube leakage.The twogroups of patients were restored, and no deaths. Conclusion  Compare to the non-elderly group, although the risk of elderly patients in the LC patients and postoperative complications are relatively large, However, if we do the perioperative management well, LC, like the elderly and young patients is feasible and safe and can obtain satisfactory results.
【Key words】 Gallstone  Laparoscopic cholecystectomy  Elderly 
        随着胆囊疾病应用腹腔镜胆囊切除术(Laparo—scopiccholecystectomy，LC)治疗方法的日趋成熟，LC的微创优势已得到充分肯定并成为胆囊良性疾病行胆囊切除术的“金方案”，风险小，疗效满意。但多数老年患者由于机体机能下降，同时又往往伴有各种基础疾病，因此增加了手术风险和难度。为评估老年胆囊结石患者LC治疗的风险和疗效，以进一步指导临床治疗方案的选择和预后的评估，本文将我院2007年1月至2008年12月施行LC的老年患者与非老年患者的临床资料对比分析，探讨LC在治疗老年胆囊结石中的临床价值和安全性。
        1  资料与方法
        1.1一般资料
        老年组患者178例，男性52例，女性126例，男女之