经皮经肝胆囊穿刺引流术与腹腔镜胆囊切除术联合治疗急性重症胆囊炎的效果分析  

Analysis of the Effect of Percutaneous Transhepatic Gallbladder Drainage Combined with Laparoscopic Cholecystectomy in the Treatment of Severe Acute Cholecystitis

作　　者：卜振兴 杜攀 佟雪 BU Zhenxing;DU Pan;TONG Xue(Department of Emergency,Dongchangfu District Traditional Chinese Medicine Hospital,Liaocheng,Shandong,252000,China)

机构地区：[1]聊城市东昌府区中医院急诊科,山东聊城252000

出　　处：《中外医疗》2024年第25期60-63,共4页China & Foreign Medical Treatment

摘　　要：目的分析急性重症胆囊炎(severe acute cholecystitis,SAC)患者采用经皮经肝胆囊穿刺引流术(percu⁃taneous transhepatic gallbladder drainage,PTGD)联合腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)治疗的效果。方法方便选取2020年8月—2023年7月聊城市东昌府区中医院急诊科收治的72例SAC患者为研究对象,根据不同手术方法分为对照组和研究组,各36例。对照组采用急诊LC治疗,研究组采用急诊PTGD联合LC治疗。比较两组术中指标与术后恢复情况、炎症因子及术后并发症情况。结果研究组术中失血量低于对照组,LC手术操作时间、体温恢复时间、住院时间均短于对照组,差异有统计学意义(P均<0.05)。术后,研究组C反应蛋白、白细胞介素-6水平均低于对照组,差异有统计学意义(P均<0.05)。研究组并发症总发生率为0,低于对照组的16.67%(6/36),差异有统计学意义(χ^(2)=4.546,P<0.05)。结论PTGD与LC联合治疗SAC能够加快患者的术后康复速度,缩短LC手术操作时间,减少术中失血量,抑制炎症反应,降低术后并发症发生风险。Objective To analyze the effect of percutaneous transhepatic gallbladder drainage(PTGD)combined with laparoscopic cholecystectomy(LC)in patients with severe acute cholecystitis(SAC).Methods A total of 72 SAC pa⁃tients admitted to the emergency department of Liaocheng Dongchangfu District Traditional Chinese Medicine Hospi⁃tal from August 2020 to July 2023 were conveniently selected as the research objects.According to different surgical methods,they were divided into control group and study group,with 36 cases in each group.The control group was treated with emergency LC,and the study group was treated with emergency PTGD combined with LC.The intraopera⁃tive indexes,postoperative recovery,inflammatory factors and postoperative complications were compared between the two groups.Results The intraoperative blood loss in the study group was lower than that in the control group,and the operation time of LC,body temperature recovery time and hospitalization time were all shorter than those in the con⁃trol group(all P<0.05).After operation,the levels of C-reactive protein and interleukin-6 in the study group were both lower than those in the control group,and the differences were statistically significant(both P<0.05).The total in⁃cidence of complications in the study group was 0,which was lower than 16.67%(6/36)in the control group,and the difference was statistically significant(χ^(2)=4.546,P<0.05).Conclusion The combination of PTGD and LC in the treat⁃ment of SAC can accelerate the postoperative recovery rate of patients,shorten the operation time of LC,reduce the in⁃traoperative blood loss,inhibit the inflammatory response,and reduce the risk of postoperative complications.

关 键 词：腹腔镜胆囊切除术 急性重症胆囊炎 经皮经肝胆囊穿刺引流术 

分 类 号：R4[医药卫生—临床医学]