血必净配合经皮肝胆道穿刺引流术治疗急性重症胆管炎的疗效分析

Curative Effect of Xuebijing Combined with Percutaneous Transhepatic Cholangial Drainage on Acute Cholangitis of Severe Type

目的探讨血必净配合经皮肝胆道穿刺引流术(Percutaneous Transhepatic Cholangial Drainage,PTCD)治疗急性重症胆管炎(Acute Cholangitis of Severe Type,ACST)临床疗效。方法回顾性选取2019年1月-2020年12月湛江中心人民医院收治的103例ACST患者的临床资料,按不同治疗方案分为4组:PTCD+抗菌素+血必净组31例、PTCD+抗菌素组25例、抗菌素+血必净组25例、单纯抗菌素组22例。观察各组患者治疗前后血清白细胞(White Blood Cells,WBC)、血小板(Platelets,PLT)、降钙素原(Procalcitonin,PCT)、C反应蛋白(Creactive Protein,CRP)、总胆红素(Total Bilirubin,TBIL)、住院时间等相关指标变化,并比较各组患者的疗效,从而进一步探讨血必净治疗ACST的临床意义。结果治疗前,4组ACST患者血清WBC、PLT、PCT、CRP及TBIL各项指标比较,差异无统计学意义(P均>0.05)。治疗后4组患者的TBIL、PCT、CRP比较,差异有统计学意义(P均<0.05),其中PTCD+抗菌素+血必净组患者的TBIL平均(23.3±12.9)μmol/L、PCT平均(3.4±1.8)ng/L和CRP平均(16.6±7.3)mg/L,较其余3组均显著降低,差异有统计学意义(P均<0.05)。治疗后4组患者的血清WBC、PLT比较,差异无统计学意义(P均>0.05)。单纯抗菌素组平均住院(7.1±2.0)d,较其余3组显著减少,差异有统计学意义(P<0.05)。4组疗效比较,差异有统计学意义(P<0.05),其中PTCD+抗菌素组及PTCD+抗菌素+血必净组的总有效率更高。结论血必净配合PTCD能明显缓解ACST患者的病情,血必净对促进病情恢复具有积极的临床意义。

Objective To investigate the clinical effect of Xuebijing combined with percutaneous transhepatic cholangial drainage(PTCD)in the treatment of acute cholangitis of severe type(ACST).Methods The clinical data of 103 ACST patients admitted to Zhanjiang Central People's Hospital from January 2019 to December 2020 were retrospectively selected.They were divided into four groups according to different treatment plans:31 cases in the PTCD+antibiotic+Xuebijing group,25 cases in the PTCD+antibiotic group,25 cases in the antibiotic+Xuebijing group,and 22 cases in the simple antibiotic group.Observe the changes in serum white blood cells(WBC),platelets(PLT),procalcitonin(PCT),C-reactive protein(CRP),total bilirubin(TBIL),and hospital stay before and after treatment in each group of patients,and compare the therapeutic effects of each group of patients,in order to further explore the clinical significance of Xuebijing in treating ACST.Results Before treatment,there was no statistically significant difference in serum WBC,PLT,PCT,CRP,and TBIL indicators among the four groups of ACST patients(all P>0.05).After treatment,there were statistically significant differences in TBIL,PCT,and CRP among the four groups of patients(all P<0.05).Among them,the average TBIL of patients in the PTCD+antibiotic+Xuebijing group was(23.3±12.9)µmol/L,average PCT(3.4±1.8)ng/L,and average CRP(16.6±7.3)mg/L were significantly lower than the other three groups,and the difference was statistically significant(all P<0.05).After treatment,there was no statistically significant difference in serum WBC and PLT among the four groups of patients(both P>0.05).The average hospitalization time of the simple antibiotic group was(7.1±2.0)days,which was significantly reduced compared to the other three groups,and the difference was statistically significant(P<0.05).The therapeutic effects of the four groups were compared,and the differences were statistically significant(P<0.05).Among them,the total effective rate of the PTCD+antibiotic group and the PTCD+antibiotic+Xuebijing group was higher.Conclusion Xuebijing combined with PTCD can obviously alleviate the condition of ACST patients,and Xubijing has positive clinical significance in promoting the recovery of the condition.