清热利胆颗粒辅助治疗胆囊穿刺引流术后腹腔镜胆囊切除术疗效观察  

Clinical Efficacy of Qingre Lidan Granules in Assisting Treatment in Laparoscopic Cholectomy of Acute Cholecystitis Patients after Percutaneous Transhepatic Gallbladder Drainage

作　　者：马婧嫄 万星 刘航宇 张标 张庆凯[1] 张桂信[1,2] 尚东[1,2] 李爽[1] MA Jing-yuan;WAN Xing;LIU Hang-yu;ZHANG Biao;ZHANG Qing-kai;ZHANG Gui-xin;SHANG Dong;LI Shuang(Third Department of General Surgery,First Affiliated Hospital of Dalian Medical University,Liaoning,116011;Institute of Integrative Medicine,Dalian Medical University,Liaoning,116011)

机构地区：[1]大连医科大学附属第一医院普外三科,辽宁116011 [2]大连医科大学中西医结合研究院,辽宁116011

出　　处：《中国中西医结合杂志》2024年第11期1314-1319,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.82000075)。

摘　　要：目的 观察清热利胆颗粒辅助治疗胆腑郁热证急性胆囊炎(AC)患者在超声引导下胆囊穿刺引流术(PTGD)术后行腹腔镜胆囊切除术(LC)的临床疗效。方法 筛选2018年1月—2023年4月在大连医科大学附属第一医院就诊AC患者3 061例,符合纳入标准159例。根据PTGD术后是否应用清热利胆颗粒分为观察组(50例)及对照组(109例)。对照组给予常规西医治疗,观察组在常规西医治疗基础上加用清热利胆颗粒治疗。观察LC手术时间、术中出血量、LC中转开腹例数、胆囊坏死或脓肿例数、困难LC(手术时间90 min或胆囊三角解剖困难)例数,LC术后并发症、引流管摆放、引流管摆放时间、住院天数、术后住院天数、住院费用。结果 与对照组比较,观察组LC手术时间、术中出血量及困难LC比例更少(P<0.05,P<0.01)。观察组术后住院天数、术后引流管摆放率、住院费用均少于对照组(P<0.05)。术后并发症发生率两组比较,差异无统计学意义(P>0.05)。结论 对于PTGD术后患者,加用清热利胆颗粒治疗可有效提高LC安全性,缩短手术时间,减少术中出血,降低引流管摆放率,并且有助于术后恢复,减少术后住院时间及住院费用。Objective To observe the clinical efficacy of Qingre Lidan Granules(QRLDG)for assisting treatment in laparoscopic cholecystectomy(LC)of acute cholecystitis(AC)patients after percutaneous transhepatic gallbladder drainage(PTGD).Methods A retrospective collection was conducted on 3061 AC patients at First Affiliated Hospital of Dalian Medical University from January 2018 to April 2023.Of them,159 met the inclusion criteria.All the patients were assigned to the observation group(50 cases)and the control group(109 cases)according to whether used QRLDG after PTGD.Patients in the control group received conventional Western medicine,while those in the observation group additionally took QRLDG.The duration of LC surgery,intraoperative bleeding volume,number of cases of LC conversion to open surgery,number of cases of gallbladder necrosis or abscess,number of cases of difficult LC(surgery time 90 min or difficulty in dissecting the gallbladder triangle),postoperative complications of LC,placement of drainage tubes,placement time of drainage tubes,length of hospital stay,postoperative hospitalization days,and hospitalization expenses were observed.Results Compared with the control group,LC surgery time,intraoperative bleeding volume,and difficulty in LC were shorter in the observation group(P<0.05,P<0.01).Postoperative hospitalization days,placement rate of postoperative drainage tube,and hospitalization expenses were lesser in the observationgroup than in the control group (P<0.05). There was no statistical difference in the incidence of postoperativecomplications between the two groups( P>0.05). Conclusions For AC patients after PTGD,additional useof QRLDG effectively improved the safety of LC surgery,shortened the surgical time,reduced perioperativebleeding,decreased the placement rate of drainage tubes,helped post-operative recovery,and loweredpost-operative hospitalization time and expenses.

关 键 词：清热利胆颗粒 急性胆囊炎 超声引导下胆囊穿刺引流术 腹腔镜下胆囊切除术 胆腑郁热证 中西医结合 

分 类 号：R657.4[医药卫生—外科学]