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目的:探讨高原地区老年慢性阻塞性肺疾病(COPD)患者行腹腔镜胆囊切除术(LC)的治疗特点。方法:选取我院自2008年—2010年实施的COPD合并胆囊结石患者72例的临床资料进行分析。结果:72例均伴有不同程度的慢性支气管炎、肺气肿、肺心病等COPD病史,全组行LC治疗,术后并发肺部感染10例,2例术后呼衰经呼吸机辅助呼吸24小时脱机,无死亡病例。结论:在高海拔、低气压、低氧分压环境下,充分做好术前营养支持、肺部炎症控制和围手术期管理监测和治疗,老年COPD合并胆囊结石患者行LC是安全有效。
Objective: To investigate the characteristics of laparoscopic cholecystectomy (LC) in elderly patients with chronic obstructive pulmonary disease (COPD) in the plateau. Methods: The clinical data of 72 patients with COPD complicated by gallstone in our hospital from 2008 to 2010 were analyzed. Results: All 72 patients had history of COPD, including chronic bronchitis, emphysema and cor pulmonale. All the patients underwent LC treatment. There were 10 cases of postoperative pulmonary infection and 2 cases of postoperative respiratory failure with ventilator assisted breathing 24 hours off, no deaths. CONCLUSION: Preoperative nutritional support, pulmonary inflammation control and perioperative management monitoring and treatment are well performed under high altitude, low pressure and hypoxic partial pressure conditions. LC is safe and effective in elderly patients with COPD and gallstone disease.