摘要
目的探讨分析经皮经肝胆囊穿刺置管引流术(percutaneous transhepatic gallbladder drainage,PTGD)、腹腔镜胆囊切除术序贯治疗急性化脓性胆囊炎的疗效。方法选取2020年2月至2021年2月石首市长恒康复医院收治的急性化脓性胆囊炎患者94例,采用随机数字表法分为试验组(n=47)与参照组(n=47)。参照组患者直接采用腹腔镜胆囊切除术治疗。试验组患者则采用PTGD、腹腔镜胆囊切除术序贯治疗。统计两组患者手术用时、手术出血量、术后体温恢复时间、引流时间、疼痛程度、住院天数以及中转开腹率,并对比两组患者术后感染、腹水、胆道出血、胆漏等相关并发症的发生情况。结果试验组患者的手术出血量少于参照组,手术用时、术后体温恢复时间、引流时间、住院天数短于参照组,疼痛程度评分低于参照组,差异均有显著性(P<0.05)。试验组和参照组患者的中转开腹率分别为4.26%(2/47)、17.02%(8/47),差异有显著性(χ^(2)=4.029,P<0.05)。试验组患者的术后相关并发症发生率为6.38%,参照组患者的术后相关并发症发生率为21.28%,差异有显著性(P<0.05)。结论采用PTGD、腹腔镜胆囊切除术序贯治疗急性化脓性胆囊炎患者,能降低患者中转开腹率,促进患者术后恢复,降低术后并发症的发生风险。
Objective To investigate the efficacy of percutaneous transhepatic gallbladder drainage(PTGD)and laparoscopic cholecystectomy in the sequential treatment of acute suppurative cholecystitis.Method A total of 94 patients with acute suppurative cholecystitis admitted to Shishou Changheng Rehabilitation Hospital from February 2020 to February 2021 were selected and divided into experimental group(n=47)and reference group(n=47)by random number table method.The control group was treated with laparoscopic cholecystectomy.The experimental group received sequential treatment with PTGD and laparoscopic cholecystectomy.The time of operation,amount of surgical blood loss,postoperative temperature recovery time,drainage time,pain degree,length of hospital stay and the probability of conversion to laparotomy were counted between the two groups,and the incidence of postoperative infection,abdominal effusion,biliary bleeding,biliary leakage and other related complications were followed up and compared between the two groups.Result The amount of surgical bleeding in the experimental group was less than that in the reference group,and the operation time,postoperative temperature recovery time,drainage time and hospitalization days were shorter than that in the reference group,and the pain degree score was lower than that in the reference group,with significant differences(P<0.05).The conversion rates of patients in the experimental group and the reference group were 4.26%(2/47)and 17.02%(8/47),respectively,with significant difference(χ^(2)=4.029,P<0.05).The incidence of postoperative complications was 6.38%in the experimental group and 21.28%in the reference group,and the difference was significant(P<0.05).Conclusion Sequential treatment of acute suppurative cholecystitis with PTGD and laparoscopic cholecystectomy can reduce the probability of patients switching to open,promote postoperative recovery and reduce the risk of postoperative complications.
作者
胡小庆
HU Xiaoqing(Surgery Department of Shishou Changheng Rehabilitation Hospital,Hubei Shishou 434400,China)
出处
《临床普外科电子杂志》
2022年第3期122-125,共4页
Journal of General Surgery for Clinicians(Electronic Version)
关键词
急性化脓性胆囊炎
经皮经肝胆囊穿刺
腹腔镜胆囊切除术
序贯
疗效
Acute suppurative cholecystitis
Percutaneous transhepatic cholecystectomy
Laparoscopic cholecystectomy
Sequential
Curative effect
