经皮肝胆囊穿刺引流术后择期经脐单孔腹腔镜胆囊切除术治疗老年急性胆囊炎患者的疗效及安全性分析  

Efficacy and safety of selective transumbilical single-port laparoscopic cholecystectomy for elderly patients with acute cholecystitis after percutaneous hepatic and gallbladder puncture and drain-age

作　　者：艾志国[1] 程玉[1] 张旭[1] AI Zhi-guo;CHEN Yu;ZHANG Xu(Department of Hepatobiliary Surgery,Huizhou Central People's Hospital,Huizhou,Guangdong 516002,China)

机构地区：[1]惠州市中心人民医院肝胆外科,广东惠州516002

出　　处：《岭南现代临床外科》2020年第2期184-187,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探究经皮肝胆囊穿刺引流(PTGD)术后择期经脐单孔腹腔镜胆囊切除术(TUSLC)在老年急性胆囊炎(AC)中的应用效果。方法选取我院80例老年AC患者(2017年12月~2018年12月),根据手术方案分为对照组(n=40)和观察组(n=40),分别施行PTGD+传统腹腔镜胆囊切除术(LC)、PTGD+TUSLC。观察2组术中出血量、手术时间、白细胞恢复时间、胃肠功能恢复时间、住院时间、并发症,对比术后1 d、3 d、7 d疼痛程度(VAS)。结果与对照组比较,观察组白细胞恢复时间、住院时间、胃肠功能恢复时间较短,术中出血量较少(P<0.05);与对照组比较,术后1 d、3 d、7 d观察组VAS评分较低(P<0.05);与对照组比较,观察组并发症发生率较低(P<0.05)。结论PTGD术后择期行TUSLC,有助于减少老年AC患者术中出血量,缓解术后疼痛,降低并发症发生风险,缩短康复进程。Objective To explore the effect of transumbilical single-port laparoscopic cholecystecto-my(TUSLC)in elderly patients with acute cholecystitis(AC)after percutaneous transhepatic gallblad-der drainage(PTGD).Methods Eighty elderly patients with AC in our hospital(from December 2017 to December 2018)were divided into control group(n=40)and experimental group(n=40)according to the operation plan.PTGD+traditional laparoscopic cholecystectomy(LC)and PTGD+TUSLC were per-formed respectively.The bleeding volume,operation time,recovery time of white blood cells,recovery time of gastrointestinal function,hospitalization time and complications of the two groups were observed,and the pain degree(VAS)of 1,3 and 7 days after operation was compared.Results Compared with the control group,the recovery time of white blood cells,hospital stay and gastrointestinal function in the experimental group were shorter,and the amount of bleeding during operation was less(P<0.05);compared with the control group,the VAS score of the experimental group was lower on the 1st,3rd and 7th day after operation(P<0.05);compared with the control group,the incidence of complications in the experimental group was lower(P<0.05).Conclusion Selective TUSLC after PTGD is helpful to re-duce the blood loss,relieve the pain,reduce the risk of complications and shorten the rehabilitation pro-cess of elderly AC patients.

关 键 词：急性胆囊炎 老年 PTGD TUSLC LC 

分 类 号：R657.4[医药卫生—外科学]