超声引导下胆囊穿刺造瘘术在老年性急性胆囊炎治疗中疗效对比性研究  

Comparative study on the effect of ultrasound-guided gallbladder puncture fistula in the treatment of senile acute cholecystitis

作　　者：刘雪平[1] 余春[1] 周余旺[1] 刘庆华[1] 张峰[1] LIU Xueping;YU Chun;ZHOU Yuwang;LIU Qinghua;ZHANG Feng(Department of Ultrasound, Quzhou Heople＇s Hospital of Zhejiang Province, Quzhou 324000, Chin)

机构地区：[1]浙江省衢州市人民医院超声科,浙江衢州324000

出　　处：《中国现代医生》2017年第30期104-107,共4页China Modern Doctor

基　　金：浙江省衢州市科技项目(2016074)

摘　　要：目的评价超声引导下胆囊穿刺造瘘术治疗老年急性胆囊炎的临床疗效。方法将我院2014年11月~2016年10月期间收治的94例老年急性胆囊炎患者根据选择治疗方式的不同分为造瘘术组(n=34)、外科手术组(n=31)和保守组(n=29),造瘘术组患者接受超声引导下胆囊穿刺造瘘术治疗,外科手术组患者接受胆囊切除术治疗,保守组患者接受保守治疗(禁食、输液、纠正水、电解质紊乱等),对比三组患者的临床治疗效果。结果 (1)造瘘术组患者炎症得到控制时间与外科手术组比较无显著性差异(P>0.05),明显短于保守组(P<0.05)。(2)造瘘术组患者并发症发生率为5.88%,低于外科手术组的22.58%和保守组的31.03%(P<0.05),外科手术组与保守组并发症发生率比较存在明显差异(P<0.05)。(3)造瘘术组患者的治疗总有效率为94.12%,与外科手术组的93.55%比较无明显差异(P>0.05),与保守组的68.97%比较存在明显差异(P<0.05),外科手术组与保守组比较存在明显差异(P<0.05)。(4)造瘘术组患者的住院时间短于外科手术组和保守组(P<0.05),治疗费用与外科手术组和保守组比较无明显差异(P>0.05)。结论超声引导下胆囊穿刺造瘘术治疗老年急性胆囊炎,并发症少,疗效可靠,术后恢复快,能够有效减轻患者经济负担。Objective To evaluate the clinical efficacy of ultrasound-guided gallbladder puncture fistula for the treat- ment of acute cholecystitis in the elderly. Methods 94 patients with senile acute cholecystitis admitted in our hospital from November 2014 to October 2016 were divided into the fistula group （n=34）,the surgical group （n=31） and conser- vative group （n=29）, according to the choice of treatment. The patients in the fistula group underwent gallbladder punc-ture and fistula treatment. The patients in the surgical group received cholecystectomy and the conservative group re-ceived conservative treatment （fasting, infusion, corrected water, electrolyte disorder, etc.）. The clinical treatment effect between the three groups of patients was compared. Results ⑴There was no significant difference in the control time of inflammation between the fistula group and the surgical group （P〉0.05）, and the control time of inflammation in the fistula group was significantly lower than that in the conservative group （P〈0.05）. （2） The complication rate was 5.88%. in the patients of the fistula group, which was lower than that in the surgical group（22.58%） and 31.03% in the conser- vative group（P〈0.05）. There was significant difference in the incidence of complications between the surgical group and the conservative group （P〈0.05）. （3） There was no significant difference in total treatment effect between the fistula group （94.12%） and the surgical group （93.55%）,（P〉0.05）. And there was significant difference in total treatment effect between the surgical group （93.55%） and the conservative group （68.97%）,（P〈0.05）. （4） The length of hospital stay in the fistula group was shorter than that of the surgical group and the conservative group（P〈0.05）. There was no signifi-cant difference in the cost of treatment between the surgical group and the conservative group（P〉0.05）. Conclusion Ul-trasound-guided gallbladder

关 键 词：老年性急性胆囊炎 超声 胆囊穿刺造瘘术 临床疗效 并发症 

分 类 号：R657.4[医药卫生—外科学]