Analysis Of The Benefits Of Different Treatment Methods For Aged Acute Cholecystitis

Objective: Since most elderly people suffer from various basic diseases and their basic state is poor,there is still no consensus on their treatment methods.Therefore,the analysis of the benefits of different treatment methods for acute cholecystitis in the elderly provides a reference for the selection of clinical treatment methods.Methods:We retrospectively collected patients with acute cholecystitis from July2012 to November 2017 in our hospital.Patients with obstruction of biliary obstruction caused by age less than 65 years with biliary stones and biliary tumors were excluded.243 patients included in the study were divided into drugs.The treatment group,gallbladder puncture treatment group,emergency surgical treatment group,and puncture + elective surgery group were used to analyze the general conditions,clinical efficacy,and treatment outcomes.Results: Among the 243 patients included in the study,the grade grade was Grade II,and the average age was 76±4.1 years.Among them,71(29.2%)were in the drug treatment group,51(71.8%)were improved,and the improvement rate was the lowest in the four groups;gallbladder puncture treatment There were 72 patients(29.6%)and63 patients(87.5%)improved.The condition(age,fever ratio,ASA score,prevalence of underlying diseases,etc.)was the heaviest in the four groups;67 patients(27.6%)were treated with emergency surgery.),64 cases(95.5%)improved;33 cases(13.6%)in the puncture + elective surgery group,32 cases(97.0%)improved,of which the heavier condition(15 cases;45.5%)suggested that the surgeon choose the treatment Methods: Relatively lighter patients(18 cases;54.5%)requested the treatment for their families.This study screened out the patients with the same basic status(grade grade II,ASA score <3)in the emergency treatment group and the puncture + elective surgery group for comparative analysis.The total length of hospital stay(P<0.001)and total cost(P<0.001)were significantly higher in the puncture and elective surgery group than in the emergency surgical group.Both of the two treatments had their own trauma and complications,so the complication rate(P >0.05),Postoperative pain scores(P>0.05)were also higher than those in the emergency surgery group.However,the P values ??were all greater than 0.05,which was not statistically significant.Excluding the part of the gallbladder puncture in the puncture and elective surgery group,statistical analysis was performed only on the emergency surgical treatment and elective surgical treatment of the same basic condition(grade score II,ASA score<3).The emergency operation was performed on the surgical index.(Purgery time,surgical cost P <0.05;intraoperative bleeding,conversion laparotomy P> 0.05)and hospitalization(P <0.05)superior to elective surgery,although some P value is greater than 0.05,but it can still show that there is no elective surgery Significantly reduce the difficulty of surgery.The elective surgical treatment was superior to emergency surgery in recovery(P>0.05),and only extubation time(P>0.05)was later than emergency surgery,but the P values ??were all greater than 0.05,which could not confirm that the hospitalization time and hospitalization costs were higher than emergency Surgery is related to extubation too late.Conclusion:There are different options for the treatment of acute cholecystitis in the elderly.Drug therapy is not recommended alone,and can be used as a supplement to other treatments.For patients who meet emergency surgical conditions,especially patients with grade grade II and ASA score <3 It is recommended that surgical treatment is the first choice,which can significantly reduce the cost of treatment,and the patient's treatment cycle and length of hospital stay are short,rapid recovery,difficulty in surgery,and no significant increase in surgical complications.Puncture +elective surgery is also an ideal choice for patients who are not suitable for emergency surgery.