基层医院PTGD联合二期LC治疗老年急性化脓性胆囊炎临床体会  

Clinical experience of PTGD combined with LC in acute suppurative cholecystitis in elderly patinets

作　　者：辛维栋 张兴元[2] XIN Weidong;ZHANG Xingyuan(Binzhou Medical University,Binzhou 264003,China;Department of Hepatobiliary Surgery,the Affiliated Hospital of Binzhou Medical University)

机构地区：[1]滨州医学院,山东滨州264003 [2]滨州医学院附属医院肝胆外科

出　　处：《潍坊医学院学报》2020年第5期385-387,共3页Acta Academiae Medicinae Weifang

摘　　要：目的探讨基层医院超声引导下经皮经肝胆囊穿刺置管引流术(PTGD)联合二期腹腔镜胆囊切除术(LC)治疗老年急性化脓性胆囊炎的临床效果及安全性。方法回顾性分析胶州市人民医院2015年1月~2019年12月272例手术治疗的老年急性化脓性胆囊炎患者临床资料,按手术方式分为两组,对照组为一期行LC患者(n=146),观察组为PTGD联合二期LC患者(n=126),比较两组临床治疗效果及并发症发生情况。结果对照组术中出血量、手术时间、中转开腹率均高于观察组,差异有显著性(P<0.05),对照组术中并发症发生率及术后并发症发生率均高于观察组,差异有显著性(P<0.05)。结论 PTGD联合二期LC治疗老年急性化脓性胆囊炎具有较高的安全性,能够降低并发症发生风险,适宜于在具备条件的基层医院应用。Objective To explorethe clinical effect and safety of percutaneous transhepatic gallbladder drainage(PTGD) combined with laparoscopic cholecystectomy(LC) in the treatment of elderly patients with acute suppurative cholecystitis.Methods Two hundred and seventy-two clinical data of elderly patients with acute suppurative cholecystitis who treated by operation in Jiaozhou People’s Hospital from Jan 2015 to Dec 2019 were retrospectively analyzed.According to the operation methods,tpatients were divided into control group(n=146) and observation(n=126),patients in control group underwent primary LC,and patients in observation group received PTGD combined with LC,clinical effects and complications were compared between observation group and control group.Results Intraoperative blood loss,operation time and conversion rate of laparotomy were higher in control group than in obeservation group,difference is significant in statistics(P<0.05).Incidence of intraoperative and postoperative complications in control group were higher than in observation group,difference is significant in statistics(P<0.05).Conclusion PTGD combined with two-stage LC in the treatment of elderly patients with acute suppurative cholecystitis had high safety,could reduce the risk of complications,and was suitable for the application in qualified primary hospitals.

关 键 词：化脓性胆囊炎 急性 PTGD 腹腔镜胆囊切除术 并发症 

分 类 号：R657.41[医药卫生—外科学]