经皮经肝胆囊穿刺置管引流术后进行择期腹腔镜手术对急性胆囊炎患者近期疗效分析

Short-term Efficacy and Safety of Percutaneous Transhepatic Gallbladder Drainage Combined with Elective Laparoscopic Surgery in Patients with Acute Cholecystitis

目的探讨经皮经肝胆囊穿刺置管引流术联合择期腹腔镜手术治疗急性胆囊炎患者的近期疗效及安全性。方法随机选取我院2018年1月-2019年1月收治的急性胆囊炎患者80例作为研究对象,采用随机数法将其分成对照组与观察组,每组40例。对照组患者接受急诊腹腔镜手术治疗,观察组患者接受经皮经肝胆囊穿刺置管引流术联合择期腹腔镜手术治疗。比较两组患者一般指标、症状改善时间、并发症、免疫球蛋白水平。结果观察组患者手术流血量、术前准备时间及手术时间少于对照组(P<0.05),住院时间少于对照组(P<0.05)。观察组患者凝血功能恢复、白细胞恢复、体温恢复、休克纠正时间短于对照组(P<0.05),有统计学意义。观察组患者并发症发生总率低于对照组(P<0.05),有统计学意义。术前两组患者免疫球蛋白水平差异比较无统计学意义(P>0.05),无统计学意义;术后两组患者免疫球蛋白水平较术前升高,其中观察组患者IgG、IgA、IgM水平高于对照组(P<0.05),有统计学意义。结论经皮经肝胆囊穿刺置管引流术联合择期腹腔镜手术治疗急性胆囊炎安全有效,能减少术后并发症发生,改善机体免疫功能,减少手术出血量。

Objective To investigate the short-term efficacy and safety of percutaneous transhepatic gallbladder drainage combined with elective laparoscopic surgery in patients with acute cholecystitis.Methods 80 patients with acute cholecystitis in our hospital from January 2018 to January 2019 were enrolled,and divided into two groups by random number table methods,each with 40 cases.Control group received emergency laparoscopic surgery,while observation group received percutaneous transhepatic gallbladder drainage combined with elective laparoscopic surgery.The general indicators,symptom improvement time,complications and immunoglobulin levels were compared between groups.Results The blood loss,preoperative preparation time and operation time of observation group were shorter than those of control group(P<0.05),and the hospital stay length was shorter in observation group than in control group(P<0.05).The time of coagulation function recovery,leukocyte recovery,body temperature recovery and shock correction in observation group was significantly shorter than that in control group(P<0.05).The total complication rate of observation group was significantly lower than that of control group(P<0.05).The immunoglobulin IgG,IgA,and IgM levels had no significant difference between groups before surgery(P>0.05),which were increased in both groups after surgery(P<0.05),and were higher in observation group than in control group(P<0.05).Conclusion Application of percutaneous transhepatic gallbladder drainage combined with elective laparoscopic surgery can effectively and safely reduce the postoperative complication,ameliorate immune function and reduce the blood loss for patients with acute cholecystitis.