经皮经肝胆囊穿刺造瘘术治疗老年重症结石性胆囊炎的临床疗效

Clinical Efficacy of Percutaneous Transhepatic Cholecystostomy for the Treatment of Elderly Patients with Severe Calculous Cholecystitis

目的 探究经皮经肝胆囊穿刺造瘘术治疗老年重症结石性胆囊炎的临床疗效.方法 选取荣县中医院外科2015年7月—2016年10月收治的老年重症结石性胆囊炎150例作为研究对象,随机分为观察组和对照组各75例.对照组给予常规手术治疗,观察组给予经皮经肝胆囊穿刺造瘘术,观察两组患者围手术期各项指标水平,并进行统计学分析.结果 观察组围手术期中术中出血量、凝血功能恢复时间、休克纠正时间、体温恢复时间、白细胞恢复时间及手术时间均优于对照组,差异有统计学意义（P〈0.05）;观察组术后多脏器功能衰竭及胆瘘情况优于对照组,差异有统计学意义（P〈0.05）.结论 经皮经肝胆囊穿刺造瘘术治疗老年重症结石性胆囊炎可缓解临床症状,降低术后并发症的发生率,提高临床治疗效果,并具有安全、可靠、操作简便等特点,值得临床应用.

Objective To study the clinical efficacy of percutancous transhepatic cholecystostomy for the treatment of elderly patients with severe calculous cholecystitis. Methods One hundred and fifty cases of elderly patients with severe calculous cholecystitis in Department of Surgery in Rongxian Hospital of Traditional Chinese Medicine from July in 2015 to October in 2016 were selected. The patients were divided into the observation group and the control group at random with 75 cases in each group. The control group was given conventional treatment, while the observation group was treated by percutaneous transhepatic cholecystostomy. Index levels of perioperative period of two groups were observed and analyzed statistically. Result The amount of bleeding during operation, recovery time of blood coagulation function, time of shock correction, temperature recovery time, recovery time of white blood cell and operation time of observation group during paraoperation period were better than those of the control group, and the differences were statistically significant （P〈 0.05）. The situation of postoperative multiple organ failure and biliary fistula in the observation group was better than those in the control group with statistically significant differences （P〈0.05）. Conclusion Percutaneous transhepatic cholecystostomy for the treatment of elderly patients with severe cholecystitis can alleviate clinical symptoms, reduce the occurrence of postoperative complications, improve the clinical treatment effect, and is safe, reliable and simply operative. It is worthy of clinical application.