两种不同术式治疗急性非结石性胆囊炎合并急性腹膜炎的临床效果及安全性分析  

Clinical effect and safety analysis of two different operation methods in the treatment of acute non calculous cholecystitis with acute peritonitis

作　　者：聂洲 NIE Zhou(The Second Department of Surgery,Jingzhou Hospital of Traditional Chinese Medicine,Jingzhou,Hubei,434000,China)

机构地区：[1]湖北省荆州市中中医院外二科,湖北荆州434000

出　　处：《当代医学》2021年第13期24-26,共3页Contemporary Medicine

摘　　要：目的评估对急性非结石性胆囊炎合并急性腹膜炎患者采用胆囊穿刺引流术及胆囊造瘘术治疗的临床效果及安全性。方法选取2019年1月至2019年12月本院收治的急性非结石性胆囊炎合并急性腹膜炎患者92例作为研究对象,根据随机数字表法分为观察组(采用胆囊穿刺引流术治疗,n=46)和对照组(采用胆囊造瘘术治疗,n=46),比较两组临床效果、手术前后血清炎性因子及肝脏功能指标、术后并发症发生情况。结果观察组患者手术时间、术中出血量、术后首次排气时间、住院时间以及住院费用均明显低于对照组,差异有统计学意义(P<0.05);两组患者抗生素应用时间比较差异无统计学意义。观察组患者术后CRP、TNF-α、IL-6、TBIL、ALT以及AST均明显低于对照组,差异有统计学意义(P<0.05)。观察组患者术后并发症发生率为13.04%,明显低于对照组的32.61%,差异有统计学意义(P<0.05)。结论急性非结石性胆囊炎合并急性腹膜炎患者采用胆囊穿刺引流术治疗临床效果较好,可明显降低患者机体炎性因子水平,并保护肝脏功能,术后并发症较少,值得临床推广应用。Objective To assess the clinical effect and safety of two different operation methods in the treatment of acute non calculous cholecystitis with acute peritonitis.Methods 92 cases patients with acute non calculous cholecystitis with acute peritonitis in our hosipital form January 2019 to December 2019 were selected as the research subjects,and divided into the observation group(treated with puncture and drainage of gallbladder,n=46)and the control group(treated with cholecystostomy,n=46).Compared the clinical effect,serum inflammatory factors and liver function indexes before and after operation,postoperative complications between two groups.Results The operation time,intraoperative hemorrhage,first postoperative exhaust time,hospitalization time and hospitalization cost of the observation group were significantly lower than the control group,the difference was statistically significant(P<0.05);there was no significant difference of the antibiotic application time between two groups.The CR,TNF-α,IL-6,TBIL,ALT and AST of the observation group postoperative were significantly lower than the control group,the difference was statistically significant(P<0.05).The incidence of postoperative complications of the observation group was 13.04%,which was significantly lower than the control group of 32.61%,the difference was statistically significant(P<0.05).Conclusion The clinical effect of puncture and drainage of gallbladder in the treatment of acute non calculous cholecystitis with acute peritonitis is better,and can regulate the inflammatory factors level and protect the liver function of the patients,the postoperative complications were less,which is worthy of popularization and application.

关 键 词：急性非结石性胆囊炎 急性腹膜炎 胆囊穿刺引流术 胆囊造瘘术 安全性 

分 类 号：R657.4[医药卫生—外科学]