摘要
目的:观察超声引导下经皮经肝胆囊穿刺置管引流术(UG-PTGD)联合腹腔镜胆囊切除术(LC)治疗老年急性胆囊炎(AC患者的效果。方法:选取2021年3月至2023年3月该院收治的104例老年AC患者进行前瞻性研究,按照随机数字表法分为观察组与对照组各52例。对照组给予LC治疗,观察组在对照组基础上联合UG-PTGD治疗,比较两组手术指标(肛门排气时间、体温复常时间、术中失血量、手术用时)水平、手术优良率、血清炎性因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)]水平、血浆应激指标[皮质醇(Cor)、肾上腺素(AD)]水平和并发症发生率。结果:观察组肛门排气时间、体温复常时间、手术用时短于对照组,术中失血量低于对照组,差异均有统计学意义(P<0.05);观察组手术优良率为98.08%,高于对照组的82.69%,差异有统计学意义(P<0.05);术后3 d,两组IL-6、CRP、Cor、AD水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为1.92%,低于对照组的15.38%,差异有统计学意义(P<0.05)。结论:UG-PTGD联合LC治疗老年AC患者可提高其手术优良率,缩短其肛门排气时间、体温复常时间、手术用时,降低其术中失血量、并发症发生率、炎性因子水平和应激指标水平,效果优于单纯LC治疗。
Objective:To observe effects of ultrasound-guided percutaneous transhepatic gallbladder drainage(UG-PTGD)combined with laparoscopic cholecystectomy(LC)in treatment of elderly patients with acute cholecystitis(AC).Methods:A prospective study was conducted on 104 elderly AC patients admitted to this hospital from March 2021 to March 2023.They were divided into observation group and control group according to the random number table method,52 cases in each group.The control group was treated with LC,while the observation group was treated with UG-PTGD on the basis of that of the control group.The operation indexes(anal exhaust time,body temperature recovery time,intraoperative blood loss,operation time)levels,the excellent and good rate of operation,the serum inflammatory factor levels[interleukin-6(IL-6),C-reactive protein(CRP)],the plasma stress indexes[cortisol(Cor),epinephrine(AD)]levels,and the incidence of complications were compared between the two groups.Results:The anal exhaust time,the body temperature recovery time and the operation time of the observation group were shorter than those of the control group,the intraoperative blood loss was lower than that of the control group,and the differences were statistically significant(P<0.05).The excellent and good rate of operation in the observation group was 98.08%,which was higher than 82.69%in the control group,and the difference was statistically significant(P<0.05).3 days after the operation,the levels of IL-6,CRP,Cor and AD in the two groups were higher than those before the operation,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 1.92%,which was lower than 15.38%in the control group,and the difference was statistically significant(P<0.05).Conclusions:UG-PTGD combined with LC in the treatment of the elderly patients with AC can improve the excellent and good rate of operation,shorten the anal exhaust time,the body temperature recovery time and the operation time,and reduce the intraoperative blood loss,the incidence of complications,the inflammatory factor levels and the stress index levels.Moreover,it is superior to single LC treatment.
作者
雷倩倩
LEI Qianqian(Department of Ultrasound of Henan Hongli Hospital,Changyuan 453400 Henan,China)
出处
《中国民康医学》
2023年第16期47-49,共3页
Medical Journal of Chinese People’s Health
关键词
急性胆囊炎
超声引导
经皮经肝胆囊穿刺置管引流术
腹腔镜胆囊切除术
炎性因子
应激反应
并发症
Acute cholecystitis
Ultrasound guidance
Percutaneous transhepatic gallbladder puncture drainage
Laparoscopic cholecystectomy
Inflammatory factors
Stress reaction
Complication
