摘要
目的探讨CT定位数字减影血管造影术(DSA)引导胆囊穿刺引流术在急性化脓性胆囊炎治疗中的应用价值。方法 2010年1月至2013年9月山东省日照市人民医院行胆囊穿刺引流术治疗的急性化脓性胆囊炎患者73例。其中23例患者行CT引导胆囊穿刺引流术,15例患者行超声引导胆囊穿刺引流术,35例患者行CT定位DSA引导胆囊穿刺引流术。比较3组患者穿刺针数、手术时间差异。结果 3组患者患者穿刺针数差异无统计学意义。超声引导胆囊穿刺引流术患者手术时间较CT引导胆囊穿刺引流术患者手术时间短,且差异有统计学意义[(47.40±6.84)min vs(53.17±7.48)min,t=2.443,P=.017];CT定位DSA引导胆囊穿刺引流术患者手术时间较超声引导胆囊穿刺引流术患者手术时间短,且差异也有统计学意义[(33.74±6.92)min vs(47.40±6.84)min,t=6.244,P=0.000]。CT定位DSA引导胆囊穿刺引流术患者术中胆汁性腹膜炎发生率为6%(1/35),低于CT引导胆囊穿刺引流术患者、超声引导胆囊穿刺引流术患者的13%(3/23)、13%(2/15)。结论 CT定位DSA引导胆囊穿刺引流术是简便、安全、有效地治疗急性化脓性胆囊炎的手段。
Objective To evaluate the value of percutaneous transhepatic gallbladder drainage in acute suppurative cholecystitis under digital subtraction angiography( DSA)-guided after CT position.Methods Seventy-third cases of acute suppurative cholecystitis in Rizhao People's Hospital from January2010 to September 2013 were divided into CT guided group( n = 23),ultrasound guided group( n = 15),and CT + DSA guided group( n = 35). The differences of the number of puncture and operating time were compared. Results The number of puncture had no significant difference among the three groups. The operating time of ultrasound guided group was significantly shorter than that of CT guided group [( 47. 40 ±6. 84) min vs( 53. 17 ± 7. 48) min,t = 2. 443,P =. 017]. The operating time of CT + DSA guided group was significntely shorter than that of ultrasound guided group [( 33. 74 ± 6. 92) min vs( 47. 40 ± 6. 84) min,t = 6. 244,P = 0. 000]. The incidence of biliary peritonitis in CT + DSA group( 6%,1 /35) was obviously lower than that in CT guided group( 13%,3 /23) and ultrasound guided group( 13%,2 /15). Conclusion Percutaneous transhepatic gallbladder drainage guided by CT + DSA is a simple,safe,effective treatment for acute suppurative cholecystitis.
出处
《中华消化病与影像杂志（电子版）》
2014年第5期22-25,共4页
Chinese Journal of Digestion and Medical Imageology(Electronic Edition)
