超声引导下经皮胆囊置管引流术治疗老年急性胆囊炎的临床观察

Clinical Observation on the Treatment of Elderly Patients with Acute Cholecystitis by Ultrasound Guided Percutaneous Drainage of Gallbladder

目的探讨经皮胆嚢穿刺置管引流术(FTGD)治疗老年急性胆囊炎的临床疗效。方法选取2012年1月—2015年1月长宁县人民医院接受住院治疗的150例老年急性胆嚢炎患者,按照患者指征及治疗方式分为3组。观察组于超声引导下行PCGD治疗,对照Ⅰ组行胆囊切除术治疗,对照Ⅱ组行胆囊造瘘术治疗。比较其症状改善和恢复时间,观察发生并发症的情况。结果观察组死亡率为0,对照Ⅰ组死亡例数为3例,死亡率6.0%,对照Ⅱ组的死亡例数为2例,死亡率4.0%,3组死亡率比较,差异无统计学意义(P>0.05)。观察组的留置导尿时间、胃肠减压时间、抗感染治疗时间与住院时间均短于对照Ⅰ组和对照Ⅱ组,差异有统计学意义(P<0.05)。治疗期间,观察组的并发症发生率为0,低于对照Ⅰ组(30.0%)和对照Ⅱ组(40.0%),差异有统计学意义(P<0.05)。结论在超声引导下对老年急性胆嚢炎患者开展经皮胆嚢置管引流具有操作简单、并发症少、安全性高等特点。

Objective To investigate the clinical effect of percutaneous puncture drainage （ PTGD） in the treatment of elderly patients with acute cholecystitis. Methods 150 cases of hospitalized elderly patients with acute cholecystitis treated in this hospital during 2012/1 --2015/1 were selected, and according to the difference of the indications and treatment, the patients were divided into three groups. In the observation group underwent ultrasound - guided PCGD treatment, the control group I underwent cholecystectomy treatment, the control group II for the treatment of gallbladder fistula. Compared with the improvement of symptoms and recovery time,complications observed. Results The mortality of observation group was 0% , the control group I and control group II were 6. 0% （3 cases） and 4. 0% （2 cases） , there was no significant difference among three groups （P 〉 0. 05 ） ; observation group of indwelling catheter time and jaundice eliminate time, time of gastrointestinal decompression, anti infection treatment time and hospitalization time were shorter than the control group Ⅰ and group Ⅱ, there was significant difference among three groups （ P 〈 0. 05 ）. Treatment period, in the observation group, the complication rate was 0, lower than that of the control group Ⅰ （ 30. 0% ） and control group Ⅱ （40. 0% ） , there was significant difference among three groups （ P 〈 0. 05）. Conclusion In the elderly patients with acute cholecystitis under ultrasound guided PCGD treatment, the operation is simple, less complications, low risk, high safety, and curative effect is remarkable.