Đánh giá kết quả sớm điều trị sỏi đường mật tái phát trên bệnh nhân từ 60 tuổi trở lên

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Tác giả: Cao Cương Nguyễn, Đức Trung Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2023

Mô tả vật lý: tr.73

Bộ sưu tập: Metadata

ID: 339340

Thêm vào giỏ Liên kết toàn văn

- Đặt vấn đề: Bệnh lý sỏi đường mật đã được biết đến từ lâu. Bệnh có thể gặp ở nhiều độ tuổi và tần suất tăng dần theo tuổi. Ở người cao tuổi, bệnh lý sỏi mật sẽ càng nguy hiểm hơn do triệu chứng lâm sàng không rõ ràng, không điển hình, đặc biệt là những bệnh lý mạn tính kèm theo. Những nguy cơ về tai biến biến chứng trên cơ địa già yếu suy nhược, giảm đề kháng dễ xảy ra.- Mục tiêu nghiên cứu 1. Khảo sát một số đặc điểm lâm sàng, cận lâm sàng, hình ảnh học của nhóm bệnh nhân từ 60 tuổi trở lên được điều trị sỏi đường mật tái phát. 2. Kết quả sớm điều trị sỏi đường mật tái phát trên bệnh nhân từ 60 tuổi trở lên. 3. So sánh một số kết quả điều trị của nhóm từ 60 tuổi trở lên với nhóm dưới 60 tuổi- Phương pháp nghiên cứu: Gồm các bệnh nhân được điều trị sỏi đường mật tái phát tại bệnh viện Bình Dân từ 01/01/2018 đến 30/06/2021. Nghiên cứu hồi cứu, cắt ngang (có phân tích và so sánh). Cỡ mẫu cho 2 nhóm >
= 60 tuổi và <
60 tuổi là 90 bệnh nhân cho mỗi nhóm. Chọn mẫu ngẫu nhiên đơn thuần.- Kết quả: Nhóm >
= 60 tuổi: tuổi trung bình: 74,03 ± 9,43. Tỉ lệ nữ : nam = 1,64. Các bệnh mạn tính kèm theo có ở nhóm >
= 60 tuổi nhiều hơn nhóm <
60 tuổi. Tam chứng Charcot chỉ có ở 22,8% trong cả 2 nhóm. Về ASA: 92,8% có phân loại mức độ I, II và nhóm >
= 60 tuổi nhiều hơn nhóm <
60 tuổi. Hình ảnh học không có sự khác biệt giữa 2 nhóm tuổi. Tỷ lệ sạch sỏi nhóm >
= 60 là 81,1%, nhóm <
60 tuổi là 85,6%, sạch sỏi chung 2 nhóm là 83,2%. Không có sự khác biệt về kết quả điều trị của cả 2 nhóm. Tai biến chảy máu trong lúc mổ cần truyền máu là tai biến hay gặp. Biến chứng ở nhóm >
= 60 tuổi biến chứng là 18,9 % và có nhiều biến chứng hơn. Thời gian hậu phẫu nhóm >
= 60 tuổi dài hơn nhóm <
60 tuổi. - Kết luận: Không có sự khác biệt về kết quả điều trị của cả 2 nhóm. Những phương pháp điều trị sỏi tái phát ít xâm hại cần được xem xét thực hiện ở đối tượng người cao tuổi để tránh các tai biến và biến chứng nặng.Abstract- Background: Cholelithiasis has been known for a long time. The disease can occur at any age and the frequency increases with age. In the elderly, bile duct stones disease will be even more dangerous due to unclear, atypical clinical symptoms, especially associated chronic diseases. Risks of complications in the weakened, decreased immune elderly easily happens.- Objectives of the study 1. Survey on some clinical, paraclinical, and imaging characteristics of the group of patients aged 60 years and older who were treated for recurrent cholelithiasis. 2. Early results of treatment of recurrent bile duct stones in patients aged 60 years and older. 3. Comparison of some treatment results of the age group 60 and older with the group under 60 years old- Research method: Includes patients who were treated for recurrent cholelithiasis at Binh Dan Hospital from January 1, 2018 to June 30, 2021. Retrospective, cross - sectional study (analyze, compare). The sample size for the 2 groups >
= 60 years old and <
60 years old was 90 patients for each group. Pure random sampling.- Results: Group >
= 60 years old: mean age: 74.03 ± 9.43. Ratio female: male = 1.64. Chronic comorbidities were more common in the >
= 60 age group than in the <
60 year old group. About ½ patients in both groups were admitted to the emergency room. Charcot triad was present in only 22.8% of both groups. About ASA: 92.8% have class I, II and group >
= 60 years old is more than group <
60 years old. On imaging, there was no difference between the 2 age groups in extrahepatic bile duct stones, intra-extrahepatic bile duct stones, and intrahepatic bile duct stones. The rate of stone clearance in the group >
= 60 was 81.1%, the group <
60 years old was 85.6%, and the stone clearance rate in the two groups was 83.2%. There was no difference in treatment outcomes for both groups. Intraoperative bleeding that requires blood transfusion is a common complication. Complications in the group >
= 60 years old were 18.9% and more complications. The postoperative time in the group >
= 60 years old was longer than that in the group <
60 years old.- Conclusion: There was no difference in treatment outcomes of both groups. Minimally invasive treatments for recurrent stones should be considered in the elderly to avoid serious accidents and complications. DOI: 10.59715/pntjmp.1.3.10

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