超声引导下经皮经肝胆囊穿刺置管引流术在治疗老老年急性胆囊炎的临床价值  

Clinical Value of Ultrasound-guided Percutaneous Transhepatic Gallbladder CatheterDrainage in the Treatment of Acute Cholecystitis in the Very Elderly

作　　者：李玥铭 李璐 蒲猛 韩者艺 姚克纯 刘禧 范校周 Li Yueming;Li Lu;Pu Meng;Han Zheyi;Yao Kechun;Liu Xi;Fan Xiaozhou(Department of Ultrasound,Air Force Medical Center,Air Force Medical University,Beijing 100142,China;Outpatients Department,The 8th Rest Center for Retired Cadres in Haidian,Beijing Garrison Region,Beijing 100195,China;Department of Hepatobiliary Surgery,Air Force Medical Center,Air Force Medical University,Beijing 100142,China;Department of Gastroenterology,Air Force Medical Center,Air Force Medical University,Beijing 100142,China)

机构地区：[1]空军军医大学空军特色医学中心超声诊断科,北京市100142 [2]北京卫戍区海淀第八退休干部休养所门诊部,北京市100195 [3]空军军医大学空军特色医学中心肝胆外科,北京市100142 [4]空军军医大学空军特色医学中心消化内科,北京市100142

出　　处：《中国超声医学杂志》2023年第5期536-539,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金面上项目(No.81873562);空军特色医学中心优秀青年人才计划项目(No.22YXQN015)。

摘　　要：目的 探讨超声引导下经皮经肝胆囊穿刺置管引流术(UG-PTGD)在治疗老老年急性胆囊炎(AC)的临床价值。方法 对UG-PTGD治疗的64例老老年AC患者临床资料进行回顾,对比分析治疗前后体温、降钙素原、C反应蛋白、白细胞计数、嗜中性粒细胞百分率、血淀粉酶、脂肪酶、总胆红素、谷丙转氨酶及凝血相关指标的差异及治疗后引流情况、进食时间、并发症。结果 64例患者均一次置管成功。与术前相比,除血淀粉酶及凝血相关指标未见统计学意义,其余指标均有统计学意义(P<0.05);术后引流通畅,恢复进食时间、出院时间依次为(4.97±4.37)d、(17.75±13.42)d,未有操作相关并发症。9例因其他系统疾病死亡,55例患者明显好转,15例择期进行胆囊切除术。结论 UG-PGCD操作成功率高,可显著缓解老老年AC患者症状,并为择期手术创造条件。Objective To investigate the clinical value of ultrasound-guided percutaneous transhepatic gallbladder drainage(UG-PTGD)in the treatment of acute cholecystitis(AC)in the very elderly.Methods The clinical data of 64very elderly AC patients treated with UG-PTGD in Air Force Medical Center of Air Force Medical University were reviewed,and the differences of body temperature,procalcitonin,C-reactive protein,leukocyte count,percentage of neutrophil,blood amylase,blood lipase,total bilirubin,alanine aminotransferase and coagulation-related indexes before and after treatment were compared and analyzed.Drainage condition,eating time and complications after treatment were recorded.Results All 64patients were successfully catheterized once.Compared with pre-operation,there were statistical differences in other indicators(P<0.05)except blood amylase and coagulation-related indexes.Postoperative drainage was streamline,and feeding time and discharge time were(4.97±4.37)days and(17.75±13.42)days,respectively,and no surgery-related complications were found.9patients died due to other systemic diseases,55patients improved significantly,and 15patients underwent cholecystectomy.Conclusions UG-PTGD has a high success rate of operation,which can significantly alleviate the infective symptoms of the very elderly AC patients,and could offer conditions for elective surgery.

关 键 词：急性胆囊炎 老老年 经皮经肝胆囊穿刺置管引流术 介入超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R657.41[医药卫生—诊断学]