90例病毒性肝炎合并胆囊炎临床治疗分析

Clinical treatment for 90 cases of viral hepatitis with cholecystitis

目的探讨病毒性肝炎合并胆囊炎的临床治疗方案。方法选取本院2010～2012年收治的90例病毒性肝炎合并胆囊炎患者,随机分为对照组和观察组各45例;两组患者予以护肝治疗,并对慢性肝炎患者进行抗病毒治疗;观察组在此基础上额外给予抗生素治疗7d。2周后,根据临床有效率及治疗前后血清肝功、凝血功能指标改善情况对比治疗结果,总结治疗经验。结果治疗2周,观察组显效6例、有效35例、临床有效率为91.1%;对照组显效5例、有效37例、临床有效率为93.3%;两组相比,差异无统计学意义(x2=0.154,P=0.695)。血清生化指标:治疗后,两组患者的血清肝功能指标ALT、AST、TBil和凝血功能指标PT、PTA差异均无统计学意义(P>0.05)。结论病毒性肝炎合并胆囊炎的临床治疗重在保护肝功能,可根据患者个体情况进行抗病毒治疗,无需使用抗生素。

Objective To explore the clinical treatment method of viral hepatitis with cholecystitis. Methods 90 patients of viral hepatitis with cholecystitis accepted by our hospital from 2010 to 2012 were selected as the research object,which were divided into 45 cases of control group and 45 cases of observation group. All the patients were treated with liver protection drugs while those with chronic viral hepatitis were given antiviral drugs in the same time,on the basis of which patients in observation group were given antibiotics. After 2 weeks,the treatment experiences were summarized by analyzing the treatment resuhs assessed according to clinical effective rate as well as the levels of serum biochemical indexes before and after treatment. Results The clinical effective rate of the observation group was 91.1% with 6 cases of marked effective and 35 cases of effective while that of the control group was 93.3% with 5 cases of marked effective and 37 cases of effective,and there was no significant difference between each other in the curative effect after 2 weeks＇ therapy（P 〉 0.05）. Serum biochemical indices：there was no significant difference in the patients＇ serum liver function indexes of ALT,AST,TBil and blood coagulation indexes of PT,PTA after treatment between the two groups（P 〉 0.05）. Conclusion Our research result shows that liver protection is the key point for the treatment of hepatitis with cholecystitis, which indicates that it is feasible to give antiviral treatment on the basis of liver protection without antibiotics.