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作 者:刘文清 刘辉 包丽溱 LIU Wenqing;LIU Hui;BAO Lizhen(Department of General Surgery,Jiangyin Hospital of Traditional Chinese Medicine,Jiangyin,Jiangsu Province,214400 China)
出 处:《系统医学》2024年第6期124-127,共4页Systems Medicine
摘 要:目的探究超声引导下经皮经肝胆囊穿刺置管引流术(Ultrasound Guided Percutaneous Transhepatic Gall bladder Drainage,UG-PTGD)治疗对老年急性胆囊炎患者疼痛程度的影响。方法选取江阴市中医院于2020年3月—2023年6月收治的93例老年急性胆囊炎患者为研究对象,按治疗方式不同分为对照组(46例)、观察组(47例)。对照组予以胆囊造瘘术治疗,观察组行UG-PTGD治疗。手术完成后,对比两组围术期指标、术后疼痛程度及炎性因子水平。结果观察组术中出血量、手术时间、拔管时间、排气时间及下床时间均优于对照组,差异有统计学意义(P均<0.05)。观察组术后即刻、术后第3天、第7天视觉模拟评分(Visual Analog Scale,VAS)为(1.29±0.31)分、(5.03±1.41)分和(3.54±0.54)分,均低于对照组,差异有统计学意义(t=3.872、2.106、2.980,P均<0.05)。观察组白细胞计数(White Blood Cell Count,WBC)、白细胞介素-6(Interleukin-6,IL-6)、C反应蛋白(C-reactive Protein,CRP)水平均低于对照组,差异有统计学意义(P均<0.05)。结论针对老年急性胆囊炎患者,采取UG-PTGD治疗具有一定手术操作优势,有助于降低患者的炎性因子水平,且减轻患者术后的疼痛程度。Objective To explore the effect of ultrasound guided percutaneous transhepatic gallbladder drainage(UG�PTGD)on pain degree in elderly patients with acute cholecystitis.Methods A total of ninety-three elderly patients with acute cholecystitis admitted to Jiangyin Hospital of Traditional Chinese Medicine from March 2020 to June 2023 were selected as the study objects,and were divided into control group(46 cases)and observation group(47 cases)ac cording to different treatment methods.The control group was treated with cholecystostomy,and the observation group was treated with UG-PTGD.After the operation,the perioperative indexes,postoperative pain and inflammatory fac tors were compared between the two groups.Results The intraoperative blood loss,operation time,extubation time,ex haust time and getting out of bed time in observation group were better than those in control group,and the differences were statistically significant(all P<0.05).The score of Visual Analog Scale(VAS)of the observation group were(1.29±0.31)points,(5.03±1.41)points,(3.54±5.54)points,lower than those of the control group immediately after sur gery,at the third and seventh day after surgery,and the differences were statistically significant(t=3.872,2.106,2.980,all P<0.05).The levels of white blood cell count(WBC),interleukin-6(IL-6)and C-reactive protein(CRP)in observation group were lower than those in control group,and the differences were statistically significant(all P<0.05).Conclusion For elderly patients with acute cholecystitis,UG-PTGD treatment has certain advantages in surgical op eration,which can help reduce the level of inflammatory factors and reduce the degree of postoperative pain of pa tients。
关 键 词:超声引导下经皮经肝胆囊穿刺置管引流术 胆囊造瘘术 疼痛程度 围术期指标 炎性因子水平
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