超声引导经皮经肝胆囊穿刺引流术治疗老年急性胆囊炎的效果分析

陶平; 吴向阳; 张磊

doi:10.3969/j.issn.1001-5256.2016.10.021

超声引导经皮经肝胆囊穿刺引流术治疗老年急性胆囊炎的效果分析

DOI: 10.3969/j.issn.1001-5256.2016.10.021

南京医科大学附属南京医院普外科

详细信息

中图分类号: R657.41
计量
- 文章访问数: 2328
- HTML全文浏览量: 38
- PDF下载量: 460
- 被引次数: 0
出版历程
- 出版日期: 2016-10-20

Clinical effect of ultrasound-guided percutaneous transhepatic gallbladder drainage in treatment of acute cholecystitis in elderly patients

Department of General Surgery, Nanjing Hospital Affiliated to Nanjing Medical University

摘要

摘要:
目的探讨超声引导经皮经肝胆囊穿刺引流术（PTGD）治疗老年急性胆囊炎的效果。方法回顾分析南京医科大学附属南京医院2010年6月-2015年6月实施PTGD的62例患者临床资料。测量患者PTGD术前,术后24、72 h的体温,WBC计数,肝功能和胆囊大小。计量资料组内治疗前后比较采用配对t检验。结果所有患者均一次性手术成功,PTGD术后24 h的体温较术前比较差异无统计学意义（t=0.91,P>0.05）,术后72 h体温降至正常,与术前比较差异有统计学意义（t=9.96,P<0.01）。术后24、72 h患者的WBC计数、ALT、AST水平较术前均明显下降,而胆囊长径及宽径较术前明显缩小,差异均有统计学意义（P值均<0.05）。结论超声引导PTGD是治疗不能耐受手术的危重老年急性胆囊炎患者的一种安全、有效的微创方法。
- 胆囊炎,急性 /
- 超声检查 /
- 引流术 /
- 老年人
Abstract:
Objective To investigate the clinical effect of ultrasound-guided percutaneous transhepatic gallbladder drainage( PTGD) in the treatment of acute cholecystitis in elderly patients. Methods A retrospective analysis was performed for the clinical data of 62 patients who underwent PTGD in Nanjing Hospital Affiliated to Nanjing Medical University from June 2010 to June 2015. The body temperature,white blood cell( WBC) count,liver function,and gallbladder size were measured before PTGD and at 24 and 72 hours after PTGD. The paired t-test was used for comparison of continuous data before and after treatment within each group. Results All the patients achieved a one-time success in PTGD. There was no significant change in body temperature at 24 hours after PTGD( t = 0. 91,P > 0. 05). There were significant reductions in WBC count,alanine aminotransferase,and aspartate aminotransferase from 24 to 72 hours after PTGD,as well as a significant reduction in gallbladder size( all P < 0. 05). Conclusion Ultrasound-guided PTGD is a safe and effective minimally invasive method for the treatment of acute cholecystitis in critically ill elderly patients who are unable to undergo surgery.
- cholecystitis /
- acute /
- ultrasonography /
- drainage

HTML全文

参考文献(10)

[1]WU WR.General surgery in the age of aging[J].Chin J Pract Surg,2009,29(2):108.(in Chinese)吴蔚然.老龄化时代的普通外科[J].中国实用外科杂志,2009,29(2):108.

[2]DOLAN JP,DIGGS BS,SHEPPARD BC,et al.The national mortality burden and significant factors associated with open and laparoscopic cholecystostomy:1997-2006[J].J Gastrointest Surg,2009,13(12):2292-2301.

[3]CHEN XP.Surgery of the liver and biliary tract[M].Beijing:People's Medical Publishing House,2005:215.(in Chinese)陈孝平.肝胆外科学[M].北京:人民卫生出版社,2005:215.

[4]YU LM,HE S,GAO YH.Acute cholecystitis:WSES position statement[J].J Clin Hepatol,2015,31(2):157-159.(in Chinese)于黎明,何松,高沿航.急性胆囊炎:世界急诊外科学会立场声明[J].临床肝胆病杂志,2015,31(2):157-159.

[5]LOBERANT N,NOTES Y,EITAN A,et al.Comparison of early outcome from transperitoneal versus transhepatic percutaneous cholecystostomy[J].Hepatogastroenterology,2010,57(97):12-17.

[6]XIE MP,WANG J.Research status of acute cholecystitis in elderly patients[J].Trauma Crit Care Med,2016,4(1):62-64.解民鹏,王静.高龄患者急性胆囊炎研究现状[J].创伤与急危重病医学,2016,4(1):62-64.

[7]LI M,LI N,JI W,et al.Percutaneous cholecystostomy is a definitive treatment for acute cholecystitis in elderly high-risk patients[J].Am Surg,2013,79(5):524-527.

[8]LIU XY.The bridge to the elective operation for severe acute cholecystitis in eldly patients——percutaneous cholecystostomy under ultrasound guiding[J].Chin J Gen Surg,2012,11(5):66-67.(in Chinese)刘浔阳.老年人危、急重症急性胆囊炎通向择期手术的桥梁——超声引导下经皮胆囊置管造瘘术[J].中国普通外科杂志,2012,11(5):66-67.

[9]WANG WH.Clinical efficacy of percutaneous transhepatic cholecystostomy combined with laparoscopic cholecystectomy for elderly patients with severe calculous cholecystitis[J].J Clin Hepatol,2015,31(8):1291-1294.(in Chinese)王为华.经皮经肝胆囊穿刺造瘘术联合腹腔镜下胆囊切除术治疗60岁以上重症结石性胆囊炎患者的疗效观察[J].临床肝胆病杂志,2015,31(8):1291-1294.

[10]OKU T,HORII T,MASAKA T,et al.Clinical comparison of endoscopic naso-gallbladder drainage versus percutaneous transhepatic gallbladder drainage for acute cholecystitis[J].Nihon Shokakibyo Gakkal Zasshi,2013,110(6):989-997.

施引文献

资源附件(0)

访问统计