摘要
目的:探讨超声引导下经皮胆囊穿刺引流术治疗急性重症胆管炎的临床有效性与安全性。方法:选取2019年1月-2021年4月信宜市人民医院收治的69例急性重症胆管炎患者,全部患者均于超声引导下以经皮胆囊穿刺引流术进行治疗,统计穿刺引流成功率与相关并发症发生率,观察患者临床症状、相关生化指标变化、预后及转归情况。结果:患者超声引导经皮胆囊穿刺引流成功率100%,术后2例急诊开腹,67例持续引流。非中转开腹患者治疗后72 h腹痛、发热、黄疸、意识障碍、休克症状均显著改善或消失。治疗后72 h,患者WBC、中性粒细胞百分比、CRP、DBIL、ALT、AST、ALP与GGT均低于治疗前,差异均有统计学意义(P<0.05)。发生穿刺引流相关并发症5例,均有效处理,发生率7.25%。非中转开腹患者中,59例二期手术解除胆道梗阻,8例带管出院,无死亡病例,救治成功率100%。结论:超声引导下经皮胆囊穿刺引流术治疗急性重症胆管炎效果安全确切,可以快速改善患者临床症状及相关生化指标,为后续治疗创造良好条件,可作为急性重症胆管炎过渡性治疗方法。
Objective:To explore the clinical effectiveness and safety of ultrasound-guided percutaneous transhepatic gallbladder drainage in the treatment of acute severe cholangitis.Method:A total of 69 patients with acute severe cholangitis admitted to Xinyi City People’s Hospital from January 2019 to April 2021 were selected,all patients were treated with percutaneous gallbladder puncture and drainage under ultrasound guidance.The success rate of puncture drainage and incidence of related complications were counted,the symptoms,the changes in clinical symptoms,related biochemical indicators,the prognosis,and outcome of the patients were observed.Result:The success rate of patients with ultrasound-guided percutaneous transhepatic gallbladder drainage was 100%.2 patients received emergency laparotomy after operation,and 67 patients had continuous drainage.Abdominal pain,fever,jaundice,disturbance of consciousness,and shock symptoms in non-converted laparotomy patients were significantly improved or disappeared 72 h after treatment.72 h after treatment,the WBC,neutrophil percentage,CRP,DBIL,ALT,AST,ALP and GGT of patients were lower than those before treatment,the differences were statistically significant (P<0.05).Complications related to puncture and drainage occurred in 5 cases,all of which were effectively treated,with an incidence rate of 7.25%.Among the non-converted laparotomy patients,59 patients were treated with secondary operation to relieve biliary obstruction,and 8 patients were discharged with a tube.There were no deaths,and the success rate of treatment was 100%.Conclusion:Ultrasound-guided percutaneous transhepatic gallbladder drainage is safe and accurate in the treatment of acute severe cholangitis.It can quickly improve the patients’ clinical symptoms and related biochemical indicators,create good conditions for subsequent treatment,and can be used as a transitional treatment for acute severe cholangitis.
作者
吴明
罗生
彭艺
WU Ming;LUO Sheng;PENG Yi(Xinyi City People’s Hospital,Xinyi 525300,China)
出处
《中外医学研究》
2022年第3期158-161,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
急性重症胆管炎
超声
经皮胆囊穿刺引流术
Acute severe cholangitis
Ultrasound
Percutaneous transhepatic gallbladder drainage
