摘要
目的:探讨超声引导下经皮经肝胆道穿刺引流术(PTBD)介入治疗老年急性胆囊炎(AC)的临床效果。方法:选取2022年2月-2023年4月漳州市第三医院收治的80例老年AC患者,随机分为研究组(行PTBD介入治疗)与对照组[行腹腔镜胆囊切除术(LC)治疗],各40例。比较两组老年AC患者围手术期指标(手术时间、术中出血量、体温恢复时间、白细胞恢复时间、腹腔引流时间、住院时间)、应激反应[皮质醇(Cor)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]、肝功能[总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天门冬酸氨基转移酶(AST)、并发症。结果:研究组手术时间(32.06±6.11)min、术中出血量(41.31±5.92)mL、体温恢复时间(1.19±0.25)d、白细胞恢复时间(2.25±0.34)d、腹腔引流时间(2.99±0.42)d及住院时间(5.16±0.58)d均优于对照组,差异有统计学意义(t=11.693、14.291、17.154、16.317、11.182、10.953,P<0.05)。术后,研究组Cor(249.32±25.86)ng/mL、IL-6(14.03±2.62)ng/L及CRP(15.13±3.15)ng/L均低于对照组,差异有统计学意义(t=7.022、9.949、5.994,P<0.05)。术后,研究组TBIL(21.03±2.69)μmol/L、ALT(33.54±3.95)U/L及AST(31.19±4.43)U/L均低于对照组,差异有统计学意义(t=9.853、12.682、21.221,P<0.05)。研究组并发症发生率为12.50%(5/40),低于对照组的35.00%(14/40),差异有统计学意义(χ^(2)=5.591,P<0.05)。结论:对老年AC患者行PTBD介入治疗,手术时间较短,术中出血量较少,术后患者体温及白细胞恢复较快,明显减轻机体应激反应,改善肝功能,且并发症较少。
Objective:To explore the effect of percutaneous transhepatic biliary drainage(PTBD)under ultrasound guidance in the interventional treatment of elderly patients with acute cholecystitis(AC).Method:A total of 80 elderly patients with AC admitted to the Third Hospital of Zhangzhou from February 2022 to April 2023 were selected and they were divided into the study group(treated with PTBD intervention)and the control group[treated with laparoscopic cholecystectomy(LC),40 cases in each group.The perioperative parameters(surgical time,intraoperative bleeding volume,body temperature recovery time,white blood cell recovery time,abdominal drainage time,hospitalization time,stress response[cortisol(Cor),interleukin-6(IL-6),C-reactive protein(CRP)],liver function[total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),complications between the two groups were compared.Result:The surgical time(32.06±6.11)min,intraoperative bleeding volume(41.31±5.92)mL,body temperature recovery time(1.19±0.25)d,white blood cell recovery time(2.25±0.34)d,abdominal drainage time(2.99±0.42)d and hospitalization time(5.16±0.58)d of the study group were better than those of the control group,the differences were statistically significant(t=11.693,14.291,17.154,16.317,11.182,10.953,P<0.05).The postoperative Cor(249.32±25.86)ng/mL,IL-6(14.03±2.62)ng/L and CRP(15.13±3.15)ng/L of the study group were lower than those of the control group(t=7.022,9.949,5.994,P<0.05).The postoperative TBIL(21.03±2.69)μmol/L,ALT(33.54±3.95)U/L and AST(31.19±4.43)U/L of the study group were lower than those of the control group,the differences were statistically significant(t=9.853,12.682,21.221,P<0.05).The incidence of complications of the study group was 12.50%(5/40),which was lower than 35.00%(14/40)of the control group,the difference was statistically significant(X^(2)=5.591,P<0.05).Conclusion:PTBD intervention therapy for elderly patients with AC has a shorter surgical time,less intraoperative bleeding,faster recovery of body
作者
毕建民
柯恩明
BI Jianmin;KE Enming(The Third Hospital of Zhangzhou,Zhangzhou 363000,China;不详)
出处
《中外医学研究》
2024年第17期33-36,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
急性胆囊炎
经皮经肝胆道穿刺引流术
超声
疗效
Acute cholecystitis
Percutaneous transhepatic biliary drainage
Ultrasound
Curative effect
