摘要
目的探讨急诊内镜和急诊开腹在治疗老年急性梗阻性化脓性胆管炎（AOSC）中的效果。方法回顾性分析80例老年AOSC患者的临床资料，根据手术方式分为观察组和对照组，每组40例。观察组采用急诊内镜手术治疗，对照组采用急诊开腹手术治疗。比较两组围术期相关指标、肝功能、炎症指标及术后并发症发生率。结果观察组术后引流管留置时间、术后住院时间、腹痛及黄疸减轻所需时间、术后胃肠功能恢复所需时间均显著低于对照组，差异均有统计学意义（P均〈0．05）。两组术后直接胆红素（IBIL）、丙氨酸氨基转移酶（ALT）、γ-谷氨酰转肽酶（GGT）及中性粒细胞百分比（NEU％）、降钙素原（PCT）水平均低于治疗前；观察组术后IBIL、ALT、GGT、NEU％、PCT水平均低于对照组，差异有统计学意义（P〈0．05）。观察组并发症总发生率为5．0％，低于对照组的22．5％，差异有统计学意义（P〈0．05）。结论急诊内镜治疗老年AOSC效果显著，可促进患者康复，改善肝功能和炎症水平，安全性高，值得在临床推广。
Objective To investigate the curative effects of emergency endoscopy and emergency open surgery in elderly patients with acute obstructive suppurative cholangitis （AOSC）. Methods The clinical data of 80 elderly AOSC patients were retrospectively analyzed, and patients were divided into ob-servation group and control group according to operative methods, with 40 cases in each group. The pa-tients in observation group were treated by emergency endoscopy surgery, while the patients in control group were treated by emergency open surgery. The clinical data during peri-opcration, the liver func-tion, inflammatory markers and incidence of complications after treatment were compared between the two groups. Results The drainage tube duration, hospital stay, time for remission of jaundice, abdominal pain, and gastrointestinal function after operation in observation group were significantly shorter than in control group, the differences were statistically significant (all P 〈 0. 05). The levels of bilirubin （IBIL）, alanine aminotransferase （ALT）, γ-glutamyl-transpeptidase （GGT）, percentage of neutrophil granulocyte (NEU%) and procalcitonin （PCT） in the two groups after operation were significantly lower than those before operation, the levels of IBIL, ALT, GGT, NEU% and PCT in observation group after treatment were significantly lower than those in control group (P all 〈 0. 05). The total incidence of complications in observation group （5.0%） was significantly lower than that in control group （22. 5%), the difference was statistically significant （P 〈 0. 05). Conclusions Emergency endoscopy is effective on elderly AOSC with high safety. It can promote the rehabilitation, liver function and inflammation which is worthy of clinical application.
作者
李慧华
曾红文
Li Huihua;Zeng Hongwen(Department of Hepatobiliary Surgery, Huizhou No. 3 People＇s Hospital, Huizhou 516200, China)
出处
《中国实用医刊》
2018年第9期18-20,共3页
Chinese Journal of Practical Medicine
基金
惠州市科技计划项目（20150802）
关键词
急诊内镜治疗
急诊开腹
急性梗阻性化脓性胆管炎
肝功能
Emergency endoscopic treatment
Elderly patients
Acute obstructive suppurative cholangitis
Liver function
