经皮经肝胆囊穿刺引流术治疗高危急性胆囊炎的临床效果
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摘要
目的探讨经皮经肝胆囊穿刺引流术(PTGBD)治疗高危急性胆囊炎的临床效果。方法选取我院2014年2月至2018年2月收治的高危急性胆囊炎患者150例,根据手术方式的不同将其分成观察组(76例,PTGBD术)与对照组(74例,腹腔镜胆囊切除术)。比较两组治疗效果。结果观察组的手术时间和术中出血量均优于对照组,差异具有统计学意义(P<0.05)。术后3 d,两组体温、总胆红素、碱性磷酸酶水平、白细胞计数及腹痛评分均降低,且观察组腹痛评分低于对照组,差异具有统计学意义(P<0.05)。观察组并发症总发生率显著低于对照组,差异具有统计学意义(P<0.05)。结论 PTGBD治疗高危急性胆囊炎的临床效果显著,可减轻患者术后疼痛,并发症少,临床推广价值较高。
Objective To investigate the clinical effect of percutaneous transhepatic gallbladder drainage(PTGBD) in the treatment of high-risk acute cholecystitis. Methods A total of 150 patients with high-risk acute cholecystitis admitted in our hospital from February 2014 to February 2018 were divided into observation group(76 cases, PTGBD operation) and control group(74 cases, laparoscopic cholecystectomy). The therapeutic effects of the two groups were compared. Results The operation time and bleeding volume of the observation group were better than those of the control group, the differences were statistically significant(P<0.05). At the 3 days after operation, the body temperature, levels of total bilirubin and alkaline phosphatase, white blood cell count and abdominal pain scores of the two groups decreased, and the abdominal pain score of the observation group was lower than that of the control group, the differences were statistically significant(P<0.05). The total incidence of complications in the observation group was significantly lower than that in the control group, the difference was statistically significant(P <0.05). Conclusion PTGBD has a remarkable clinical effect in the treatment of high-risk acute cholecystitis. It can relieve the pain of patients after operation with fewer complications and has a high clinical popularization value.
Objective To investigate the clinical effect of percutaneous transhepatic gallbladder drainage(PTGBD) in the treatment of high-risk acute cholecystitis. Methods A total of 150 patients with high-risk acute cholecystitis admitted in our hospital from February 2014 to February 2018 were divided into observation group(76 cases, PTGBD operation) and control group(74 cases, laparoscopic cholecystectomy). The therapeutic effects of the two groups were compared. Results The operation time and bleeding volume of the observation group were better than those of the control group, the differences were statistically significant(P<0.05). At the 3 days after operation, the body temperature, levels of total bilirubin and alkaline phosphatase, white blood cell count and abdominal pain scores of the two groups decreased, and the abdominal pain score of the observation group was lower than that of the control group, the differences were statistically significant(P<0.05). The total incidence of complications in the observation group was significantly lower than that in the control group, the difference was statistically significant(P <0.05). Conclusion PTGBD has a remarkable clinical effect in the treatment of high-risk acute cholecystitis. It can relieve the pain of patients after operation with fewer complications and has a high clinical popularization value.
引文
[1]陈勇.经皮肝胆囊穿刺引流后择期腹腔镜手术治疗高危急性化脓性胆囊炎的效果观察[J].中国医药导刊,2016,18(12):1209-1210.
[2]郭楠,周承刚,唐晓东,等.经皮肝胆囊穿刺引流后序贯治疗高危急性化脓性胆囊炎的进展[J].国际老年医学杂志,2017,38(1):46-48.
[3]刘玉坤,董杰杰,许军,等.急性胆囊炎手术方法和时机的合理选择[J].西南国防医药,2018,28(1):87-89.
[4]中华医学会外科学分会胆道外科学组.胆囊良性疾病治疗决策的专家共识(2011版)[J].中华消化外科杂志,2011,10(1):14-19.
[5]周文华,孙红,刘继海,等.视觉模拟评分法评估急诊科拥挤度研究[J].中华急诊医学杂志,2015,24(5):512-517.
[6]王宏,寻权,杨明,等.急性胆囊炎的外科治疗方法比较分析[J].中华普通外科杂志,2017,32(2):141-144.
[7]张锟,王翔,张彤,等.急性胆囊炎患者胆汁病原菌感染特点及其对抗菌药物的耐药性分析[J].实用肝脏病杂志,2016,19(2):230-232.
[8]胡军,胡汉卿,郑军.高危急性胆囊炎经皮经肝胆囊穿刺引流术后胆囊切除时机探讨[J].现代仪器与医疗,2018,24(3):30-31.
[9]陆磊,金旭文,陆峰,等.高危急性胆囊炎患者在内镜下行胆囊引流治疗的体会[J].中华消化内镜杂志,2016,33(2):116-118.
[10]冯建忠,谢红芳,李斐,等.急性胆囊炎早期腹腔镜治疗术后并发症的高危因素分析[J].腹腔镜外科杂志,2016,21(3):201-204.
[11]陆启瑜,周阳,宛宝生.经皮肝胆囊穿刺引流联合腹腔镜胆囊切除术治疗高龄高危急性梗阻化脓性胆囊炎56例[J].昆明医科大学学报,2016,37(3):71-73.
[12]王越市,于宏,肖刚.急性胆囊炎引流治疗的进展[J].中国微创外科杂志,2018,18(2):159-162.
[13]廖重五,马苏,宋涛,等.腹腔镜胆囊摘除术与传统开腹手术治疗急性胆囊炎的临床疗效对比[J].现代生物医学进展,2016,16(26):5135-5137.
[14]汲崇亮.高危急性胆囊炎采用经皮经肝胆囊穿刺引流术治疗临床分析[J].航空航天医学杂志,2017,28(5):567-568.
[15]陶平,吴向阳,张磊.超声引导经皮经肝胆囊穿刺引流术治疗老年急性胆囊炎的效果分析[J].临床肝胆病杂志,2016,32(10):1929-1931.
[16]俞海波,陈海川,肖竣,等.经皮经肝胆囊穿刺引流术后择期行腹腔镜胆囊切除术与急诊腹腔镜胆囊切除术治疗急性胆囊炎的对比分析[J].中华普通外科杂志,2016,31(7):573-575.
[17]李义.经皮肝胆囊穿刺置管引流术对老年急性胆囊炎患者IL-2、IL-4、IL-6水平与胃肠功能的影响[J].中国老年学杂志,2017,37(5):1189-1190.
[18]胡逸人,潘江华,王奕,等.PTGD与腹腔镜胆囊切除序贯微创治疗高危急性胆囊炎疗效分析[J].浙江医学,2015,34(6):488-490.
[2]郭楠,周承刚,唐晓东,等.经皮肝胆囊穿刺引流后序贯治疗高危急性化脓性胆囊炎的进展[J].国际老年医学杂志,2017,38(1):46-48.
[3]刘玉坤,董杰杰,许军,等.急性胆囊炎手术方法和时机的合理选择[J].西南国防医药,2018,28(1):87-89.
[4]中华医学会外科学分会胆道外科学组.胆囊良性疾病治疗决策的专家共识(2011版)[J].中华消化外科杂志,2011,10(1):14-19.
[5]周文华,孙红,刘继海,等.视觉模拟评分法评估急诊科拥挤度研究[J].中华急诊医学杂志,2015,24(5):512-517.
[6]王宏,寻权,杨明,等.急性胆囊炎的外科治疗方法比较分析[J].中华普通外科杂志,2017,32(2):141-144.
[7]张锟,王翔,张彤,等.急性胆囊炎患者胆汁病原菌感染特点及其对抗菌药物的耐药性分析[J].实用肝脏病杂志,2016,19(2):230-232.
[8]胡军,胡汉卿,郑军.高危急性胆囊炎经皮经肝胆囊穿刺引流术后胆囊切除时机探讨[J].现代仪器与医疗,2018,24(3):30-31.
[9]陆磊,金旭文,陆峰,等.高危急性胆囊炎患者在内镜下行胆囊引流治疗的体会[J].中华消化内镜杂志,2016,33(2):116-118.
[10]冯建忠,谢红芳,李斐,等.急性胆囊炎早期腹腔镜治疗术后并发症的高危因素分析[J].腹腔镜外科杂志,2016,21(3):201-204.
[11]陆启瑜,周阳,宛宝生.经皮肝胆囊穿刺引流联合腹腔镜胆囊切除术治疗高龄高危急性梗阻化脓性胆囊炎56例[J].昆明医科大学学报,2016,37(3):71-73.
[12]王越市,于宏,肖刚.急性胆囊炎引流治疗的进展[J].中国微创外科杂志,2018,18(2):159-162.
[13]廖重五,马苏,宋涛,等.腹腔镜胆囊摘除术与传统开腹手术治疗急性胆囊炎的临床疗效对比[J].现代生物医学进展,2016,16(26):5135-5137.
[14]汲崇亮.高危急性胆囊炎采用经皮经肝胆囊穿刺引流术治疗临床分析[J].航空航天医学杂志,2017,28(5):567-568.
[15]陶平,吴向阳,张磊.超声引导经皮经肝胆囊穿刺引流术治疗老年急性胆囊炎的效果分析[J].临床肝胆病杂志,2016,32(10):1929-1931.
[16]俞海波,陈海川,肖竣,等.经皮经肝胆囊穿刺引流术后择期行腹腔镜胆囊切除术与急诊腹腔镜胆囊切除术治疗急性胆囊炎的对比分析[J].中华普通外科杂志,2016,31(7):573-575.
[17]李义.经皮肝胆囊穿刺置管引流术对老年急性胆囊炎患者IL-2、IL-4、IL-6水平与胃肠功能的影响[J].中国老年学杂志,2017,37(5):1189-1190.
[18]胡逸人,潘江华,王奕,等.PTGD与腹腔镜胆囊切除序贯微创治疗高危急性胆囊炎疗效分析[J].浙江医学,2015,34(6):488-490.