PTGBD穿刺引流与腹腔镜胆囊切除术联合治疗危重胆囊炎的临床疗效分析

Clinical Analysis of LC Combined with PTGBD in the Treatment of Critical Cholecystitis

目的分析PTGBD穿刺引流与腹腔镜胆囊切除术联合治疗危重胆囊炎的临床疗效。方法选取2013年1月—2014年12月间该院收治的危重胆囊炎患者共102例,根据手术方式不同分为PTGBD与LC联合组和急诊LC组。比较两组手术时间、手术出血量、腹腔引流量、腹腔引流引流时间、住院天数、费用、及患者满意度等。结果急诊LC组患者手术中出血量、腹腔引流时间以及肛门排气时间明显多于PTGDB联合LC组,差异有统计学意义(P<0.05);急诊LC组患者并发症发生率远高于PTGDB联合LC组,且患者的满意率也明显低于PTGDB联合LC组,差异有统计学意义(P<0.05)。结论PTGBD联合LC术式是目前治疗危重胆囊炎最为有效的治疗手段,值得临床推广应用。

Objective To analyze the curative effect of PTGBD （Percutaneous Transhepatie Gallbladder Drainage） combined with LC （Laparoscopic Cholecystectomy） in the treatment of severe cholecystitis. Methods 102 patients with severe cholecystitis admitted to our hospital between January 2013 and December 2014 were divided into PTGBD combine with LC group and emergency LC group. The operation time, bleeding volume, amount of abdominal drainage, time of abdominal drainage,, hospitalization days, expenses and patient satisfaction of the two groups were compared. Results The operation bleeding, abdominal drainage time, anus exhaust time of the emergency LC group in were more than those of the PTGDB combined with LC group, and the differences were statistically significant （P 〈 0.05）; the incidence of complications of the emergency LC group was far higher than that of the PTGDB combined LC group, and the satisfaction rate of the patients in the emergency LC group was significantly lower than that in the PTGDB combined with LC group, and the differences were with statistical significance （P 〈 0.05）. Conclusion PTGBD combined with LC surgery is currently the most effective treatment of severe cholecystitis treatment and it is worthy of clinical application.