超声引导下经皮经肝胆囊穿刺引流术治疗急性胆囊炎的临床效果

Clinical Efficacy of ultrasound-guided percutaneous transhepatic Gallbladder Puncture Drainage for the Treatment of acute Cholecystitis

目的 探讨超声引导下经皮经肝胆囊穿刺引流术(PTGBD)治疗急性胆囊炎(AC)患者的临床效果。方法 选取2021年9月至2023年10月在新乡市第一人民医院接受治疗的AC患者共计100例,以随机数字表法分为研究组(n=50)与对照组(n=50),对照组采用腹腔镜胆囊切除术(LC)治疗,研究组采用超声引导下PTGBD治疗,对两组围手术期指标、疼痛程度[视觉模拟评分法(VAS)]、肝功能指标[血清碱性磷酸酶(ALP)、间接胆红素(IBIL)、总胆红素(TBIL)]、炎性应激指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、白细胞计数(WBC)]、术后并发症进行比较。结果 研究组手术时间、肛门首次排气时间、住院时间较对照组短,术中出血量较对照组少,差异具有统计学意义(P <0.05);两组术后VAS评分较术前下降,且研究组术后VAS评分低于对照组,差异有统计学意义(P <0.05);两组术后ALP、IBIL、TBIL水平较术前下降,且研究组术后上述指标水平均低于对照组,差异具有统计学意义(P <0.05);两组术后TNF-α、IL-6、CRP、WBC水平较术前下降,且研究组术后上述指标均低于对照组,差异具有统计学意义(P <0.05);研究组术后并发症发生率(4.00%)低于对照组(18.00%),差异具有统计学意义(P <0.05)。结论 超声引导下PTGBD应用于AC患者治疗中,能够改善围手术期指标,降低疼痛程度,改善肝功能指标及炎性应激指标,减少术后并发症发生。

Objective To explore the clinical effect of ultrasound-guided percutaneous transhepatic gallbladder drainage(PTGBD) in the treatment of acute cholecystitis(AC) patients.Methods A total of 100 AC patients who received treatment at the First People's Hospital of Xinxiang City from September 2021 to October 2023 were selected.They were randomly divided into study group(n=50) and control group(n=50) using a random number table method.The control group received laparoscopic cholecystectomy(LC) treatment,while the study group received ultrasound-guided PTGBD treatment.Perioperative indicators,pain level [Visual Analog Scale(VAS)],liver function indicators [serum alkaline phosphatase(ALP),indirect bilirubin(IBIL),total bilirubin(TBIL)],and inflammatory stress indicators [tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP),white blood cell count(WBC)] and postoperative complications were measured in both groups.Results The study group had shorter surgical time,first anal exhaust time,hospitalization time,and less intraoperative bleeding compared to those in the control group,with statistically significant differences(P < 0.05);The postoperative VAS scores of the two groups decreased compared to before surgery,and the postoperative VAS scores of the study group were lower than those of the control group,with a statistically significant difference(P < 0.05);The levels of postoperative ALP,IBIL,and TBIL in the two groups decreased compared to before surgery,and the levels of the above indicators in the study group were lower than those in the control group after surgery,with statistical significance(P < 0.05);The levels of ALP,IBIL and TBIL in the two groups decreased after operation,and the levels of these indexes in the study group were lower than those in the control group,the difference was statistically significant(P < 0.05);The levels of TNF-α,IL-6,CRP and WBC in the two groups after operation were lower than those before operation,and the levels in the study group were lower than those in the control group(P < 0.05);The incidence of postoperative complications in the study group(4.00%) was significantly lower than that in the control group(18.00%)(P < 0.05).Conclusion The application of ultrasound-guided PTGBD in the treatment of AC patients can improve perioperative indicators,reduce pain levels,improve liver function indicators and inflammatory stress indicators,and reduce postoperative complications.