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  

Percutaneous gallbladder puncture drainage and laparoscopic cholecystectomy as sequential minimally invasive treatment for patients with high-risk acute cholecystitis

作　　者：胡逸人 潘江华[1] 王奕[1] 夏建克[1] 童晓春[1] 窦巩昊[1] 

机构地区：[1]温州市人民医院(温州医科大学温州市第三临床学院)普外科,325000

出　　处：《浙江医学》2015年第6期488-490,共3页Zhejiang Medical Journal

基　　金：温州市科技局项目(Y20140130)

摘　　要：目的探讨经皮经肝胆囊穿刺引流术(PTGD)与腹腔镜胆囊切除(LC)序贯微创治疗高危急性胆囊炎(AC)的疗效。方法对76例高危AC患者根据就诊时患者全身状况、心肺功能及胆囊B超检查结果 ,分别采用PTGD加延期LC治疗(36例,为PTGD组)及同期直接LC治疗(40例,为Non-PTGD组),观察并比较两组患者LC手术时间、术中失血量、中转开腹率、术后并发症发生率及住院时间。结果 PTGD组手术时间、住院时间均明显短于Non-PTGD组(t=1.96、1.84,均P<0.05);PTGD组术中失血量明显少于Non-PTGD组(t=2.03,P<0.05);PTGD组中转开腹率、术后并发症发生率均明显低于Non-PTGD组(x^2=6.74、6.97,P<0.05)。结论 PTGD与LC序贯微创治疗高危AC疗效确切、安全,值得临床推广。Objective To evaluate the efficacy of percutaneous gallbladder puncture drainage （PTGD） and laparo- scopic cholecystectomy （LC） as sequential minimally invasive treatment for patients with high-risk acute cholecystitis（AC）. Methods Seventy six AC patients were divided into two groups： 36 cases were treated with LC after PTGD （PTGD group） and 40 cases directly received LC treatment （non-PTGD group） based on the general condition, heart and lung function and B ultrasound results. Results The duration of surgery, intraoperative blood loss, length of hospital stay in PTGD group were sig- nificantly less than those in non-PTGD group （t = 1.96, 2.03, 1.84, all P〈0.05）. Laparotomy rate and postoperative complications rate in PTGD group were significantly lower than those in non-PTGD group （x^2 = 6.74 and 6.97, both P〈0.05）. Conclusion The efficacy and safety of PTGD and LC sequential minimally-invasive treatment for high-resk AC patients are satisfectory.

关 键 词：腹腔镜 胆囊切除 经皮经肝胆囊穿刺引流术 急性胆囊炎 

分 类 号：R657.41[医药卫生—外科学]