老年患者胆管结石围手术期处理分析

摘要

Objective:To analyze the perioperative treatment of elderly patients with bile duct stones.Method:The data of 200 elderly patients with bile duct stones in the surgical treatment in our hospital from February 2008 to February 2014 were retrospectively analyzed.Result:Postoperative bile leakage occurred in 6 cases,5 cases of subphrenic infection,7 cases of incision infection,1 case of intestinal adhesion,22 cases of pulmonary infection,acute respiratory failure in 7 cases,heart function not 5 cases,21 cases of arrhythmia,acute kidney function not 6 cases,subclavian central venous catheter infection in 2 cases.The secondary MOSF died of pulmonary infection in 3 cases,the others all be actively symptomatic treatment and were discharged.Conclusion:For elderly patients avoid emergency operation,pay attention to perioperative management,choose individualized operative methods according to patients condition,can reduce complications.%目的：分析老年患者胆管结石围手术期治疗。方法：回顾性分析2008年2月-2014年2月在笔者所在医院行手术治疗的200例胆管结石老年患者围手术期的资料。结果：术后出现胆漏6例，膈下感染5例，切口感染7例，肠粘连1例，肺部感染22例，急性呼吸衰竭7例，心功能不全5例，心律失常21例，急性肾功能不全6例，锁骨下中心静脉导管感染2例。其中因肺部感染继发MOSF死亡3例，其余均予以积极对症处理后痊愈出院。结论：对老年患者避免急诊手术，重视围手术期处理，根据患者身体状况选择个体化的术式，可减少并发症发生。