超声引导下经皮经肝胆囊穿刺置管引流术对高危急性胆囊炎患者炎症反应和肝功能的影响  

Effect of Ultrasound-guided Percutaneous Transhepatic Gallbladder Drainage on Inflammatory Response and Liver Function in Patients with High-Risk Acute Cholecystitis

作　　者：任海鹏[1] 郑云 武秀娟 李光辉 吕飞飞[1] REN Hai-peng;ZHENG Yun;WU Xiu-juan;LI Guang-hui;LV Fei-fei(Department of Emergency Surgery,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot,Inner Mongolia,010000,China;Department of Ultrasound,The Affiliated People's Hospital of Inner Mongolia Medical University,Hohhot,Inner Mongolia,010010,China;Department of Ultrasound,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot,Inner Mongolia,010000,China)

机构地区：[1]内蒙古医科大学附属医院急诊外科,内蒙古呼和浩特010000 [2]内蒙古医科大学附属人民医院超声科,内蒙古呼和浩特010010 [3]内蒙古医科大学附属医院超声科,内蒙古呼和浩特010000

出　　处：《现代生物医学进展》2019年第21期4080-4083,4128,共5页Progress in Modern Biomedicine

基　　金：内蒙古自治区卫生计生委科研项目(20140314)

摘　　要：目的:探讨超声引导下经皮经肝胆囊穿刺置管引流术(PTGD)治疗高危急性胆囊炎的疗效及对患者炎症反应和肝功能的影响。方法:选取2016年10月~2018年12月期间内蒙古医科大学附属医院收治的高危急性胆囊炎患者160例为研究对象,根据数字表法将患者随机分为对照组(n=80)和研究组(n=80),对照组给予胆囊造瘘术治疗,研究组给予超声引导下PTGD治疗,比较两组患者治疗后临床疗效、炎症反应以及肝功能指标变化情况,记录两组术后并发症发生情况。结果:研究组有效率高于对照组,住院时间短于对照组(P<0.05)。对照组术后3 d、术后5 d以及研究组术后1 d、术后3 d、术后5 d白细胞计数、中性粒细胞百分比、C反应蛋白(CRP)水平均较术前降低(P<0.05);研究组术后1 d、术后3 d、术后5 d白细胞计数、中性粒细胞百分比、CRP水平均低于对照组(P<0.05)。两组患者术后1 d、术后3 d、术后5 d丙氨酸转氨酶(ALT)、总胆红素(TB)水平均较术前下降,且研究组低于对照组(P<0.05)。研究组术后并发症总发生率低于对照组(P<0.05)。结论:超声引导下PTGD治疗高危急性胆囊炎,疗效确切,可有效减轻机体炎症反应、肝损伤,同时还可减少术后并发症发生率,具有较高的临床应用价值。Objective: To investigate the efficacy of ultrasound-guided percutaneous transhepatic gallbladder drainage(PTGD) in the treatment of high-risk acute cholecystitis and its effect on inflammatory response and liver function in patients. Methods: 160 patients with high-risk acute cholecystitis who were admitted to the Affiliated Hospital of Inner Mongolia Medical University from October 2016 to December 2018 were selected as the research objects. According to the digital table method, the patients were randomly divided into control group(n=80) and study group(n=80). The control group was treated with biliary fistula, and the study group was treated with PTGD under the ultrasound-guided. The clinical efficacy, inflammatory response and liver function indexes of the two groups were compared after treatment. The complications of the two groups were recorded. Results: The effective rate of the study group was higher than that of the control group, and the hospitalization time was shorter than that of the control group(P<0.05). The leucocyte count, neutrophil percentage and C-reactive protein(CRP) in the control group at 3 d after operation, 5 d after operation and the study group at 1 d after operation, 3 d after operation, 5 d after operation were all lower than those before operation(P<0.05). The leucocyte count, neutrophil percentage and CRP in the study group at 1 d after operation, 3 d after operation, 5 d after operation were lower than those in the control group(P<0.05). The levels of alanine aminotransferase(ALT) and total bilirubin(TB) in the two groups at 1 d after operation, 3 d after operation, 5 d after operation were decreased before operation, and those in the study group were lower than those in the control group(P<0.05). The total incidence rate of postoperative complications in the study group was lower than that in the control group(P<0.05).Conclusion: Ultrasound-guided PTGD is effective in the treatment of high-risk acute cholecystitis. It can effectively alleviate inflammatory reaction and liver inj

关 键 词：经皮经肝胆囊穿刺置管引流术 高危 急性胆囊炎 疗效 炎症反应 肝功能 

分 类 号：R657.41[医药卫生—外科学]