彩色多普勒超声仪联合数字减影血管造影术引导胆囊穿刺引流术在老年高危胆囊炎患者治疗中的应用价值  

The value of color doppler ultrasonography combined with digital subtraction angiography in the treatment of senile high risk cholecystitis

作　　者：廖重五[1] 郑晨[1] 白正忠 马苏[1] LIAO Chongwu;ZHENG Chen;BAI Zhengzhong(Department of General Surgery,Xi’an Central Hospital(Xi’an 710004))

机构地区：[1]西安市中心医院普外一科,西安710004 [2]陕西省榆林市横山区人民医院,榆林719199

出　　处：《陕西医学杂志》2019年第10期1278-1280,共3页Shaanxi Medical Journal

基　　金：国家自然科学基金资助面上项目(81770521)

摘　　要：目的:探讨彩超联合数字减影血管造影术指导胆囊穿刺引流术在老年高危胆囊炎治疗中的应用价值。方法:将收治的行胆囊穿刺引流术的老年高危胆囊炎患者86例作为研究对象,随机分为研究组和对照组各43例,研究组患者在彩超联合数字减影血管造影术(DSA)引导下行胆囊穿刺引流术(PTGBD),对照组患者在DSA引导下建立PTGBD,之后所有患者择期行腹腔镜胆囊切除术(LC),观察两组患者穿刺次数、透视时间、穿刺时间、辐射暴露剂量以及并发症发生情况。结果:研究组患者手术成功率为95.35%,明显高于对照组81.40%,病死率为2.33%明显低于对照组的11.63%,组间比较差异具有统计学意义(P<0.05);研究组患者穿刺次数、穿刺透视时间、总穿刺时间以及辐射暴露剂量等指标水平均明显低于对照组,差异具有统计学意义(P<0.05);研究组患者不良反应发生率为4.65%,明显低于对照组18.60%,组间比较差异具有统计学意义(P<0.05)。结论:彩超联合数字减影血管造影术引导胆囊穿刺引流术治疗老年高危胆囊炎患者效果显著,安全可靠,可推广使用。Objective:to investigate the value of color Doppler ultrasound combined with digital subtraction angiography in the treatment of cholecystitis in elderly patients with high-risk cholecystitis.Methods:In our hospital from January 2015 to January 2017 treated by puncture and drainage of gallbladder in elderly high-risk cholecystitis in 86 patients as the research object,randomly divided into study group and control group with 43 cases in each group,patients in study group were treated with digital subtraction angiography in ultrasound combined(Digital Subtraction Angiography,DSA)guided puncture and drainage of gallbladder(percutaneous transhepatic gallbladder drainage,PTGBD),patients in the control group set up under the guidance of DSA PTGBD,after all the patients after undergoing laparoscopic cholecystectomy(Laparoscopic,Cholecyctectomy,LC)were observed in two groups of puncture,puncture time,fluoroscopy time and radiation exposure dose and the incidence of complications.Results:The success rate of patients in study group was 95.35%,81.40%higher than the control group,the mortality rate was 2.33%and 11.63%was significantly lower than the control group,the difference was statistically significant(P<0.05);patients in the study group,the number of puncture,puncture,puncture time and fluoroscopy time total radiation exposure dose levels were significantly lower than the control group,the difference was statistically significant(P<0.05);patients in the study group,the incidence of adverse reactions was 4.65%,significantly lower than the control group 18.60%,the difference was statistically significant(P<0.05).Conclusion:color Doppler ultrasound combined with digital subtraction angiography guided gallbladder drainage in the treatment of elderly high-risk cholecystitis patients with significant effect,safe and reliable,can be used widely.

关 键 词：老年高危胆囊炎 胆囊穿刺引流术 彩超 数字减影血管造影术 对比研究 

分 类 号：R575.61[医药卫生—消化系统]