经皮肝胆囊穿刺引流后择期腹腔镜手术治疗高危急性化脓性胆囊炎的效果观察

Effect Observation of Selective Laparoscopic Operation in the Treatment of High Risk Acute Suppurative Cholecystitis after Percutaneous Gallbladder Puncture and Drainage

目的：探讨高危急性化脓性胆囊炎（ASC）应用经皮肝胆囊穿刺引流（PTGD）后择期腹腔镜胆囊切除术（LC）治疗的临床效果。方法：选取笔者所在医院2012年6月～2015年12月收治且行PTGD后择期LC治疗的43例高危ASC患者为观察组，另选同期43例于入院后72h内行LC治疗的高危ASC患者为对照组。记录比较观察组PTGD前后总胆红素（TBIL）、碱性磷酸酶（ALP）及白细胞计数（WBC），两组LC中转开腹率及术后并发症。结果：观察组PTGD后TBIL、ALP及WBC，均较术前显著改善，差异有统计学意义（P＜0.01）。结论：高危ASC应用PTGD后择期LC治疗效果切实，明显改善患者预后，具有较高临床参考价值。

Objective: To investigate the clinical effect of selective laparoscopic cholecystectomy (LC) in patients with high risk acute suppurative cholecystitis (ASC) after percutaneous gallbladder puncture and drainage(PTGD). Methods: 43 cases of high-risk ASC treated with PTGD after LC treatment in our hospital from June 2012 to December 2015 were selectedas the observation group,and 43 cases of high-risk ASC treated with LC within 72h afer being admitted to our hospital of the same period were selected as the control group.The total bilirubin(TBIL),alkaline phosphatase(ALP) and white blood cell count(WBC) of the observation group were recorded and compared before and after PTGD,and the rate of conversional opensurgery and postoperative complications of the two groups were also recorded and compared.Results: The TBIL,ALP and WBCin the observation group significantly improved after PTGD when compared with those before the surgery,the difference was statistically significant (P<0.01).Conclusion:The application of elective LC in the treatment of high risk ASC after PTGD has practical effect,can significantly improve the prognosis of patients with a high clinical reference value.