Cohort Study Of Elderly Patients With Acute Abdomen Treated By Minimally Invasive Techniques

Objective To compare the application effect of traditional open surgery and laparoscopic surgery in the treatment of gastrointestinal acute abdomen in elderly patients,and to explore the application of minimally invasive techniques.Methods The data was derived from 200 patients,over 65 years,with acute abdomen admitted to the first people's hospital of Xianyang city from March 2017 to February 2018.They were divided into two groups,open surgery group and laparoscopic surgery group,according to the patient's wishes.The intraoperative blood loss,operation lasting time,hospital stay,postoperative exhaust time,postoperative time getting out of bed,the postoperative complications and concurrent diseases were compared between the two groups.What happened Compare the length of hospital stay and complications with patients with concomitant disease Result(1)The operation time of the observation group was 136.96±52.63 min,which was longer than 112.63±36.96 min in control group.The difference between the groups was obvious(t=3.7832,P<0.05).The intraoperative blood loss was 100.02±42.25 ml,less than 165.39±186.63 ml in the control group with a significant difference between the two groups(t=10.6365,P<0.05).The postoperative exhaust time,postoperative time getting out of bed,and hospital stay were 35.02± 5.26 h,25.63 ±2.12 h,10.56 ± 7.56 d in the observation group,shorter than 49.96 ± 10.69 h,33.36 ±5.69 h,16.89 ± 9.63 d in the control group,with the obvious difference(t=12.6320,9.6325,5.6325,P<0.05).There were 3 cases of subcutaneous emphysema in the observation group were relieved by themselves without special treatment.In the control group,8 cases showed poor incision healing,4 cases showed adynamic intestinal obstruction,3 patients suffer of pulmonary infection,and the complicationsmentioned above were cured by conservative treatment.(2)The hospitalization time of patients with intestinal obstruction,upper gastrointestinal perforation and acute appendicitis in the observation group were 8.12±2.15 d,7.85±2.32 d,4.75±42.63 d,respectively,which were shorter than 12.85 ±8.12 d,13.23±9.52 d,7.62±3.56 d in the control group with a significant difference(t=5.6321,12.6325,10.6578,P<0.05).The postoperative exhaust time of patients with intestinal obstruction,upper gastrointestinal perforation and acute appendicitis were 34.52±5.12 h,28.52±5.27 h,22.36±5.63 h,shorter than 49.63±6.12 h,39.63±7.52 h,22.36±5.63 h in the control group with a significant difference(t=12.6325,7.9625,10.3362,P<0.05).The postoperative time getting out of bed of patients with intestinal obstruction,upper gastrointestinal perforation and acute appendicitis were 20.85±3.63 h,18.52±3.52 h,16.96±3.52 h,both shorter than 28.36±4.25 h,28.63±4.02 h,16.96±3.52 h in the control group,along with an obvious difference(t=9.6325,8.6632,14.11145,P<0.05).The intraoperative blood loss of patients with intestinal obstruction,upper gastrointestinal perforation and acute appendicitis was 75.42±22.15 ml,58.96±26.36 ml,34.32±24.52 ml,which were less than 75.42±22.15 ml,138.56±61.25 ml,99.63±44.52 ml in the control group(t=8.6258,10.2362,18.996 3,P < 0.05).(3)Of78 patients were without concurrent disease in the study,and 122 patients with concomitant disease.The average length of hospital stay(8.63±5.26 d)in 78 patients without concurrent disease was shorter than that of 122 patients with concomitant disease(12.63±10.56 d),with an obvious difference(t=12.6329,P<0.05).Copared with the average hospitalization time in patients without concomitant diseases,the average hospitalization time were 9.26±10.63 d,11.36±7.52 d,13.63±6.39 d,15.63±17.85 d in patients with one concurrent disease,two concurrent diseases,three concurrent diseases and four concurrent diseases,with a significant differences(t=9.6658,15.6325,12.0989,11.6325,P<0.05).Conclusion Laparoscopic surgery should be effective and safe in the treatment of acute abdomen in elderly patients.Compared with open surgery,laparoscopic surgery has such advantages as shorter operation time,mini-invasion,less complications and fast recovery.