超声引导下经皮经肝胆囊穿刺引流术治疗急重症胆囊炎的临床疗效分析  

Clinical Analysis of Ultrasound-guided Percutaneous Transhepatic Gallbladder Drainage for Acute and Severe Cholecystitis

作　　者：芦雪娇 李竞[1] 张立春[1] 李甜甜[1] 梅丽霞[1] LU Xue-jiao;LI Jing;ZHANG Li-chun;LI Tian-tian;MEI Li-xia(Department of Ultrasound,Qiqihar First Hospital,Qiqihar,Heilongjiang Province,161000 China)

机构地区：[1]齐齐哈尔市第一医院超声科,黑龙江省齐齐哈尔161000

出　　处：《中外医疗》2021年第4期188-190,共3页China & Foreign Medical Treatment

基　　金：齐齐哈尔市科学技术计划指导性项目:超声引导下经皮经肝胆囊穿刺置管引流术对急性胆囊炎治疗的疗效评价(SFZD-2017044)。

摘　　要：目的探讨超声引导下经皮经肝胆囊穿刺引流术对急重症胆囊炎患者临床疗效的评估。方法简单随机选取2017年4月-2019年4月该院收治的重症急性胆囊炎患者120例,根据治疗方式分为:研究组(n=60)和对照组(n=60),研究组行超声引导下经皮经肝胆囊穿刺引流术(TPGBD术),对照组行腹腔镜胆囊切除术,观察两组患者住院时间、住院费用、疾病治疗总有效率和术后并发症的情况。结果研究组患者的住院时间(5.92±2.21)d和住院费用(2.02±0.61)万元,与对照组住院时间(7.24±2.63)d和住院费用(1.67±0.45)万元比较,研究组均显著少于对照组,差异有统计学意义(P<0.05)。研究组临床治疗效果明显优于对照组,差异有统计学意义(P<0.05)。研究组患者术后发生切口感染0例、出血2例和胆漏1例,对照组患者术后发生切口感染4例、出血2例和胆漏4例,研究组并发症发生率(5.00%)显著低于对照组(16.67%),差异有统计学意义(χ^(2)=4.227,P=0.04)。结论超声引导下经皮肝胆囊穿刺置管引流术治疗急性重症胆囊炎疗效显著且并发症发生率低,值得在临床上广泛应用。Objective To evaluate the clinical efficacy of ultrasound-guided percutaneous transhepatic gallbladder drainage in patients with acute and severe cholecystitis.Methods A total of 120 patients with severe acute cholecystitis in the hospital from April 2017 to April 2019 were simple ramdomly selected and divided into study group(n=60)and control group(n=60)according to the treatment method.The study group was guided by ultrasound percutaneous transhepatic gallbladder puncture and drainage(PTGBD),the control group underwent laparoscopic cholecystectomy.The length of hospitalization,hospitalization cost,total effective rate of disease treatment and postoperative complications were observed in the two groups.Results The hospitalization time(5.92±2.21)d and hospitalization expenses(2.02±0.61)ten thousand yuan of the patients in the study group were compared with the control group’s hospitalization time(7.24±2.63)d and the hospitalization expenses(1.67±0.45)ten thousand yuan.Significantly less than the control group,the difference was statistically significant(P<0.05).The clinical treatment effect of the study group was significantly better than that of the control group,and the difference was statistically significant(P<0.05).In the study group,0 cases of incisional infection,2 cases of bleeding,and 1 case of biliary leakage occurred in the study group.4 cases of incisional infection,2 cases of bleeding,and 4 cases of biliary leakage occurred in the control group.The complication rate of the study group(5.00%)significantly lower than the control group(16.67%),the difference was statistically significant(χ^(2)=4.227,P=0.04).Conclusion Ultrasound-guided percutaneous hepatic gallbladder puncture catheterization and drainage in the treatment of acute severe cholecystitis has a significant curative effect and a low complication rate,and it is worthy of clinical application.

关 键 词：经皮肝胆囊穿刺置管引流术 急性胆囊炎 超声 

分 类 号：R4[医药卫生—临床医学]