急性胆囊炎联合、分期及微创治疗512例临床疗效分析  

Clinical curative effects of combined,staging and minimally invasive therapies on patients with acute cholecystitis:report of 512 cases

作　　者：王雨[1] 刘湘林[1] 阎勇[1] 戴睿武[1] 杨锁军[1] 

机构地区：[1]成都军区总医院全军普通外科中心,成都610083

出　　处：《西南国防医药》2011年第11期1195-1197,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的研究急性胆囊炎通过联合、分期及微创治疗后的临床效果。方法回顾性总结13年间我科应用单纯内科治疗、内科治疗+PTGD、急诊手术、内科治疗+择期手术及内科治疗+PTGD+择期手术治疗的512例急性胆囊炎患者的临床资料。结果 423例患者痊愈出院,89例患者好转出院,无手术死亡,无胆道损伤。其中单纯内科治疗44例;内科治疗+PTGD治疗45例;急诊手术201例(LC 90例);内科治疗+择期手术122例;内科治疗+PTGD+择期手术治疗100例。共30例患者发生48例次并发症,达9.4%(30/512)。并发症主要是胆囊出血21例(4.1%)、漏胆15例(2.9%)及腹腔感染12例(2.3%)。结论急性胆囊炎的治疗首先应遵循的是个体化原则,临床上要根据患者不同的病情合理选择治疗方式,联合、分期及微创相结合的方法治疗急性胆囊炎正是遵循了这一原则,取得了很好的临床疗效。Objective To study the clinical curative effects of the combined, staging and minimally invasive therapies on patients with acute cholecystitis. Methods A retrospective analysis was made in the clinical data of 512 patients with acute cholecystitis who underwent simply medical treatment, medical treatment combined with percutaneous transhepatic gallbladder drainage （PTGD）, emergency operation, medical treatment combined with selective operation, and medical treatment combined with PTGD and selective operation during the recent 13 years in our department. Results Four hundred and twenty three patients left the hospital with full recovery, and 89 cases discharged with improved conditions. There were no death in the operations and injury in the biliary tracts. Forty four cases simply received the medical treatment,45 cases received the medical treatment combined with PTGD and 201 cases received the emergency operation. A hundred and twenty two cases received the medical treatment combined with selective operation, and 100 cases received the medical treatment combined with PTGD and selective operation. Forty eight cases of complications occurred in 30 patients （ 9.4% , 30/512 ）, which mainly included 21 cases of bleeding of gall bladder（4.1% ）, 15 cases of leak bile （ 2.9% ） and 12 cases of abdominal ilffection （2.3%）. Conclusion The treatment of acute cholecystitis should firstly abide by the principal of individualization. Therapeutic methods should be chosen according to the different clinical conditions of patients. The method of combined, staging and minimally invasive therapies on acute cholecystitis abides by the principal above and achieves great clinical curative effects.

关 键 词：急性胆囊炎 治疗 腹腔镜胆囊切除 

分 类 号：R757.61[医药卫生—皮肤病学与性病学]