床旁经皮经肝胆囊穿刺引流术在高龄急性化脓性胆囊炎患者中的应用价值

The Bedside Percutaneous Gallbladder Puncture and Drainage of the Liver in Elderly Acute Supportive Cholecystitis

目的:对床旁经皮经肝胆囊穿刺引流术(PTGBD)在高龄急性化脓性胆囊炎患者的治疗中的应用价值进行观察并探讨。方法:抽取我院自2009年以来收治的高龄急性化脓性胆囊炎患者114例,随机将所有患者分为实验组57例和对照组57例,实验组行PTGBD治疗;同时对照组给予腹腔镜胆囊切除治疗。对两组患者治疗前和治疗后疼痛评分、实验室检查指标包括:白细胞计数、碱性磷酸酶、总胆红素和CA19-9的变化进行对比;同时比较两组患者术后并发症的情况,据此评定者两种方法对患者的影响。结果:实验组治疗前后疼痛评分、实验室检查指标包括:白细胞计数、碱性磷酸酶、总胆红素和CA19-9的变化明显优于对照组;且实验组出现并发症5例,占8.8%,死亡1例,占1.8%,对照组出现并发症13例,占22.8%,死亡3例,占5.4%,差异均具统计学意义(P<0.05)。结论:PTGBD在高龄急性化脓性胆囊炎患者的治疗中能显著改善患者体征、降低并发症率和死亡率,临床疗效显著,值得在临床上进一步推广。

Objective： Bedside percutaneous Tran hepatic gallbladder puncture the drainage （PTGBD） in the treatment of elderly acute supportive cholecystitis were observed and discussed.Methods：Extract our hospital since 2009, admitted to elderly acute supportive cholecystitis 114 patients, all patients randomly divided into experimental group, 57 patients and the control group, 57 cases the experimental group line PTGBD of treatment;while the control group received laparoscopic cholecystectomy resection. The two groups of patients before and after treatment pain score, laboratory parameters include：white blood cell count, alkaline phosphates, total bilirubin and CA19-9 in comparison;postoperative complications two methods, based thereon, assessing the impact on the patient.Results：The pain scores before and after treatment, laboratory parameters include：white blood cell count, alkaline phosphates, total bilirubin and CA19-9 changes than the control group;complications in 5 cases and the experimental group, accounting for 8.8%, 1 patient died （1.8%）, the control group had complications in 13 cases, accounting for 22.8%, 3 patients died （5.4%）, the differences were statistically significant （P〈0.05）.Conclusion： PTGBD in the treatment of elderly acute supportive cholecystitis can significantly improve the patient＆#39;s signs, reduce morbidity and mortality, a significant clinical effect, it is in clinical further promotion.