摘要
目的 探讨腹腔镜手术与经皮肝穿刺胆道引流术(PTCD)对细菌性肝脓肿的疗效及对应激反应的影响。方法 选择2017年7月至2022年6月在苏州市相城人民医院进行就诊的100例细菌性肝脓肿患者,按照随机数字表法将患者分为腹腔镜手术组、PTCD术组,各50例。两组患者入院时均予以抗生素等基础治疗,腹腔镜手术组进行腹腔镜手术,PTCD术组进行PTCD术。比较两组患者术中、术后恢复情况,检测两组患者超氧化物歧化酶(SOD)、血小板计数(PLT)、白细胞介素6(IL-6)、促肾上腺皮质激素(ACTH)水平,并观察治疗效果及并发症情况。结果 PTCD术组患者术中出血量、手术时间、引流管拔管时间、体温恢复时间均低于腹腔镜手术组,PTCD术组手术后血清SOD高于腹腔镜手术组、PLT水平低于腹腔镜手术组,差异有统计学意义(P<0.05)。PTCD术组手术后血清IL-6、ACTH水平低于腹腔镜手术组,差异有统计学意义(P<0.05)。PTCD术组有效率高于腹腔镜手术组,差异有统计学意义(P<0.05),PTCD术组并发症发生率低于腹腔镜手术组,差异有统计学意义(P<0.05)。结论 PTCD术治疗细菌肝脓肿疗效显著,安全性较高,且手术所耗时间较短,更容易操作,能够有效的抑制术后应激反应及并发症的产生。
Objective Exploring the effect of laparoscopic surgery and percutaneous transhepatic cholangial drainage(PTCD) in the treatment of bacterial liver abscess and the effect on stress response.Methods A total of 100 patients with bacterial liver abscess treated in our Suzhou Xiangcheng People's Hospital from July 2017 to June 2022 were selected.According to the random number table method,the patients were divided into laparoscopic surgery group and PTCD group,with 50 cases in each group.Both groups were given basic treatment such as antibiotics on admission,laparoscopic surgery group underwent laparoscopic surgery,PTCD group underwent PTCD.The intraoperative and postoperative recovery of the two groups were compared.Superoxide dismutase(SOD),Platelet count(PLT) and Interleukin 6(IL-6),and adrenocorticotropic hormone(ACTH) levels of the two groups were detected,and the therapeutic effects and complications were observed.Results PTCD surgery patients intraoperative blood loss,operative time,drainage tube extubation time,temperature recovery time were lower than that of laparoscopic surgery group,PTCD group operation and serum SOD was higher than after laparoscopic surgery group,the PLT level below the laparoscopic surgery group,and the difference was statistically significant(P<0.05),PTCD group operation and serum IL-6,ACTH level lower than after laparoscopic surgery group,and the difference was statistically significant(P<0.05),PTCD surgery group total effective rate was higher than laparoscopic surgery group total effective rate,and the difference was statistically significant(P<0.05),PTCD surgery group and lower incidence of complications in laparoscopic surgery group,and the difference was statistically significant(P<0.05).Conclusion PTCD in the treatment of bacterial liver abscess is highly effective,high safety,and the operation time consumption is short,easier to operate,can effectively inhibit the postoperative stress response and complications.
作者
查强
赵业剑
潘驰骏
ZHA Qiang;ZHAO Yejian;PAN Chijun(General Surgery Department,Suzhou Xiangcheng People's Hospital,Suzhou Jiangsu 215000,China)
出处
《临床研究》
2023年第11期8-11,共4页
Clinical Research
关键词
腹腔镜手术
经皮肝穿刺胆道引流
治疗效果
应激反应
laparoscopic surgery
percutaneous liver puncture for biliary drainage
therapeutic effect
stress response
