超声引导下经皮经肝胆囊穿刺置管引流术治疗高龄高危急性胆囊炎患者的临床应用  

Clinical Application of Ultrasound-guided Percutaneous Transhepatic Gallbladder Drainage in the Treatment of Elderly Patients with High-risk Acute Cholecystitis

作　　者：王鹏 翟洪涛 秦旭东 WANG Peng;ZHAI Hongtao;QIN Xudong(Department of General Surgery,Capital Medical University Shijingshan Teaching Hospital Beijing Shijingshan Hospital,Beijing 100043,China)

机构地区：[1]首都医科大学石景山教学医院北京市石景山医院普外科,北京100043

出　　处：《系统医学》2025年第6期137-141,共5页Systems Medicine

摘　　要：目的探讨超声引导下经皮经肝胆囊穿刺置管引流术(percutaneous transhepatic gallbladder catheter drainage,PTGD)在高龄高危急性胆囊炎患者中的应用效果。方法非随机选取2020年12月—2023年12月首都医科大学石景山教学医院收治的170例高龄高危急性胆囊炎患者为研究对象,根据不同手术方式分组,对照组(n=85)患者接受常规治疗手段作为干预措施,而观察组(n=85)则实施超声引导下的PTGD治疗。对比两组患者围手术期指标、肝功能、炎性应激反应及并发症发生情况。结果手术时间、首次排气时间以及住院时间相比,观察组均短于对照组,术中出血量少于对照组,差异有统计学意义(P均<0.05)。观察组肝功能指标以及炎性应激反应改善情况均优于对照组,差异有统计学意义(P均<0.05)。观察组术后并发症发生率为2.35%(2/85),低于对照组的12.94%(11/85),差异有统计学意义(χ^(2)=6.747,P<0.05)。结论在处理老年高风险急性胆囊炎患者的过程中,运用超声导航实施经皮肝脏途径的胆囊穿刺并置入导管引流技术,展现出卓越的安全性与疗效,能显著减少并发症的发生概率并对患者的肝功能产生积极改善作用。Objective To investigate the application effect of ultrasound-guided percutaneous transhepatic gallblad-der catheter drainage(PTGD)in elderly patients with high-risk acute cholecystitis.Methods A total of 170 elderly pa-tients with high-risk acute cholecystitis,admitted to Capital Medical University Shijingshan Teaching Hospital from December 2020 to December 2023,were randomly selected as the subjects of the study.According to different surgi-cal methods,the patients in the control group(n=85)received routine treatment as intervention measures,while the pa-tients in the observation group(n=85)received ultrasound-guided PTGD treatment.The perioperative indicators,liver function,inflammatory stress response and complications were compared between the two groups.Results The opera-tion time,first exhaust time,and hospitalization time in the observation group were shorter than those in the control group,and the intraoperative blood loss was lower in the observation group compared to the control group,the differ-ences were statistically significant(all P<0.05).The observation group demonstrated greater improvement in liver func-tion indices and a more favorable inflammatory stress response compared to the control group,and the differences were statistically significant(all P<0.05).The incidence of postoperative complications in the observation group was 2.35%(2/85),which was lower than 12.94%(11/85)in the control group,and the difference was statistically signifi-cant(χ^(2)=6.747,P<0.05).Conclusion In the process of dealing with elderly patients with high-risk acute cholecystitis,the use of ultrasound navigation to implement percutaneous transhepatic gallbladder puncture and catheter drainage technology shows excellent safety and efficacy,which can significantly reduce the incidence of complications and posi-tively improve the liver function of patients.

关 键 词：经皮经肝胆囊穿刺置管引流术 应用价值 急性胆囊炎 

分 类 号：R59[医药卫生—内科学]