超声引导下经皮经肝胆囊穿刺引流术对妊娠中晚期急性重症胆囊炎疗效的对比性研究  

Comparative Study on the Effect of Ultrasound-Guided Percutaneous Transhepatic Gallbladder Catheterization on Acute Severe Cholecystitis in Middle and Late Pregnancy

作　　者：王世继 闫国珍[1] 何俊峰[1] Wang Shiji;Yan Guozhen;He Junfeng(Department of Ultrasound,First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou,Neimenggu O14000,China)

机构地区：[1]内蒙古科技大学包头医学院第一附属医院病房超声科,内蒙古自治区包头市014000

出　　处：《中国超声医学杂志》2024年第1期71-73,共3页Chinese Journal of Ultrasound in Medicine

基　　金：包头医学院青年科技人才发展计划项目(No.BYJJ-QNGG2022013)。

摘　　要：目的 观察和研究超声引导下经皮经肝胆囊穿刺置管引流术(PTGD)对妊娠中晚期急性重症胆囊炎的疗效。方法 收集了妊娠中晚期急性重症胆囊炎患者共74例,年龄25~40岁,平均年龄(29.11±2.38)岁,进行回顾性研究,按照手术方式不同把患者分为两组,研究组37例行PTGD,对照组37例采取传统的胆囊造瘘术进行治疗。对比两组临床疗效、并发症发生情况、手术相关指标、手术前后致炎因子、肝功能相关指标水平。结果 研究组治疗总有效率(97.3%)高于对照组(91.9%),且研究组患者住院时间[(19.2±2.2)d]短于对照组[(22.9±2.5)d],差异均有统计学意义(P<0.05);研究组术后72小时C反应蛋白(C-resctive protein, CRP)、白细胞介素-2(Interleukin 2,IL-2)及白细胞介素-4(Interleukin 4,IL-4)、肝功能相关指标[丙氨酸转氨酶(alanine aminotransferase, ALT)、总胆红素(total bilirubin, TBil)]水平低于对照组(P<0.05);研究组并发症发生率(2.7%)低于对照组(18.9%)(P<0.05)。结论 采取超声引导下PTGD治疗对于不宜手术且非手术治疗效果差的妊娠中晚期急性重症胆囊炎患者效果良好,又因创伤小、并发症少,故值得临床推广应用。Objective To explore ultrasound-guided percutaneous transhepatic gallbladder drainage for the treatment of acute severe cholecystitis in the mid-late of pregnancy.Methods Collection of 74 patients with acute severe cholecystitis in the middle and late pregnancy,aged 25 to 40 years old,average(29.11±2.38)years old,to conduct a retrospective study,the patients were divided into two groups according to different operative methods,37 cases in the Study group were treated with PTGD,37 cases in the control group were treated with traditional cholecystostomy.The clinical curative effect,complications,relevant indexes of operation,inflammatory factors and liver function before and after operation were compared between the two groups.Results The total effective rate of treatment in the Study group(97.3%)was higher than that in the control group(91.9%),and the hospitalization time of patients in the study group was[(19.2±2.2)d]was shorter than that in the control group(22.9±2.5)days,with statistical significance(P<0.05);The levels of c-reactive protein(CRP),Interleukin-2(IL-2)and Interleukin-4(IL-4),as well as liver function related indicators such as[alanine aminotransferase(ALT)、total bilirubin(Tbil)]in the Study group were lower than those in the control group at 72 hours after surgery(P<0.05);The incidence of complications in the Study group(2.7%)was lower than that in the control group(18.9%)(P<0.05).Conclusions Ultrasound-guided percutaneous transhepatic gallbladder catheterization and drainage is effective in the treatment of severe acute cholecystitis in pregnancy with less trauma and complications,it is worthy of clinical application.

关 键 词：妊娠急性胆囊炎 经皮经肝胆囊穿刺引流 超声引导 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.255[医药卫生—诊断学]