经皮经肝胆囊穿刺引流术联合腔镜胆囊切除术在老年中度急性胆囊炎中的应用观察

Application of percutaneous transhepatic gallbladder puncture and drainage combined with endoscopic cholecystectomy in elderly patients with moderate acute cholecystitis

目的探讨老年中度急性胆囊炎患者采用经皮经肝胆囊穿刺引流术与腔镜胆囊切除术联合治疗的效果。方法本文将2019年2月-2020年2月收治的60例老年中度急性胆囊炎患者作为研究对象,按照随机数字表法分组,对照组30例患者仅采用择期腔镜胆囊切除术治疗,观察组30例患者在对照组的基础上应用经皮经肝胆囊穿刺引流术治疗。统计分析体液免疫指标、细胞免疫指标、手术前后ALP、TBIL、IBLL水平、AMY水平、白细胞计数、VAS评分及并发症发生情况。结果两组之间ALP、TBIL、IBLL水平、AMY水平、白细胞计数、VAS评分及并发症发生情况相比,观察组低于对照组;体液免疫指标、细胞免疫指标相比,观察组高于对照组,P<0.05。结论在采用择期腔镜胆囊切除术治疗老年中度急性胆囊炎的基础上联合经皮经肝胆囊穿刺引流术可提升疗效,降低择期腔镜胆囊切除术的风险,有助于患者术后尽快恢复,还可减轻患者的免疫功能损伤情况,改善体液免疫指标,减轻疼痛程度,降低并发症发生率,具有较高的应用价值。

Objective To investigate the effect of combined treatment of percutaneous transhepatic cholecystectomy and endoscopic cholecystectomy in elderly patients with moderate acute cholecystitis.Methods The research objects were 60 elderly patients with moderate acute cholecystitis,grouping according to random number table method,the control group of 30 cases were treated with selective endoscopic cholecystectomy,the observation group of 30 patients were treated with the percutaneous liver gallbladder puncture drainage on the basis of selective endoscopic cholecystectomy.Statistical analysis of humoral immunity,cellular immunity,ALP,TBIL,IBLL levels before and after operation,AMY,white blood cell count,VAS score and complications were conducted.Results The levels of ALP,TBIL,IBLL,AMY,WBC count,VAS score and complications in the observation group were lower than those in the control group.The indexes of humoral immunity and cellular immunity in the observation group were higher than those in the control group(P<0.05).Conclusion Endoscopic cholecystectomy used in the treatment of elderly moderate acute cholecystitis combined on the basis of percutaneous transhepatic gallbladder puncture drainage can improve curative effect,reduce the risk of selective endoscopic cholecystectomy,help patients with postoperative recovery,also can reduce the patient's immune function damage,improve the humoral immunity indexes,relieve pain,reduce the incidence of complications,which has high application value.