探讨超声引导下经皮胆囊穿刺置管引流术在老年急性胆囊炎临床应用的安全性

Discussion of ultrasound-guided PGCD acute cholecystitis clinical correlation elderly security analysis PGCD

目的探讨超声引导下经皮胆囊穿刺置管引流术（percutaneous gallbladder catheterized draingage，PGCD）在老年急性胆囊炎临床应用，以探究其临床价值及意义。方法选取2013年11月～2015年12月在惠州市第一人民医院进行治疗的老年急性胆囊炎患者200例，其中97例患者应用超声引导下PGCD进行治疗（Ⅰ组），103例患者行腹腔镜胆囊切除术（Ⅱ组）。检测并记录两组患者术前和术后1周的体温及白细胞数，统计两组患者的术后并发症的发生率及死亡率，以分析治疗效果。结果术后两组患者的体温均有明显下降，其中I组患者在行PGCD后1～3d体温显著低于Ⅱ组患者，差异具有统计学意义（P〈0．05），术后5。7d两组患者体温差异无统计学意义（P〉0．05）；术后两组患者的白细胞数均有下降，Ⅰ组患者1—3d内白细胞数低于Ⅱ组患者，在5～7d，两组患者的白细胞数无显著差异；Ⅱ组患者的术后并发症发生率及死亡率均显著高于Ⅰ组，两组比较差异具有统计学意义（P〈0．05）。结论超声引导下PGCD在老年急性胆囊炎的治疗上安全有效，具有重要的临床应用价值。

Objective To explore the clinical application of PGCD in elderly patients with acute cholecystitis and to examine its clinical value and significance. Methods From November 2013 to 2015, 200 elderly patients treated for acute eholecystitis over 12 months in the hospital were randomly selected. Ninety-seven patients were treated with ultrasound-guided PGCD treatment and classified as group I,and 103 patients with laparoscopie choleeystectomy were divided into two groups. To detect and record the patient＇s body temperature before and after one week and to analyze the number of white blood cells in the two groups of patients, the incidence and mortality of postoperative complications of the two groups were statistically analyzed, and the treatment effect was analyzed. Results The body temperatures of the two groups significantly decreased after the operation; those of the patients in group Ⅰ were significantly lower than those in the PGCD group after 1-3 days,and the difference was statistically significant （P 〈 0.05）. There was no significant difference in body temperature between the two groups （5-7） （P 〉 0.05）. The number of white blood cells in the two groups decreased, the number of white blood cells in group Ⅰ was lower than that of group Ⅱ patients, and there were no significant differences in the number of white blood cells between the two groups after 5-7 days. The incidence of postoperative complications and mortality were significantly higher in group Ⅱ than in group Ⅰ, and the difference was statistically significant （P 〈 0.05）. Conclusion Ultrasound-guided PGCD is safe and effective in the treatment of elderly patients with acute eholecystitis, and it has important value in clinical applications.