选择性经皮经肝胆囊穿刺置管引流在急危重症胆管炎患者中的临床应用

发布时间：2017-12-27 12:39

本文关键词：选择性经皮经肝胆囊穿刺置管引流在急危重症胆管炎患者中的临床应用　出处：《临床医药文献电子杂志》2016年35期 　论文类型：期刊论文

【摘要】：目的观察彩超引导下经皮经肝胆囊穿刺引流(Percutaneous transpepatic gallbladder dramage,PTGD)治疗急危重症胆管炎的疗效。方法选取我院2012年1月~2015年12月收治的不能耐受手术的急危重症胆管炎患者41例,入院后行PTGD治疗,检测患者穿刺前后相关指标。结果 41例患者均穿刺置管成功,穿刺引流48 h及72 h复查血白细胞、胆红素、谷丙转氨酶、疼痛视觉模拟评分(VAS)显著下降,差异有统计学意义(P0.05),胆囊大小、胆囊壁厚度及胆总管宽度均显著缩小,差异有统计学意义(P0.05)。穿刺术后发生引流管堵塞l例,引流管滑脱l例,无出血及胆瘘等并发症。穿刺术后39例进一步手术或经ERCP治疗后治愈出院,另有2例带管出院。结论对手术风险大的急危重症胆管炎患者,PTGD是一种微创、安全、可靠的治疗方法。
[Abstract]:Objective To observe the therapeutic effect of Percutaneous transpepatic gallbladder Dramage (PTGD) on acute and severe cholangitis under the guidance of color Doppler ultrasound. Methods 41 cases of patients with severe acute cholangitis who could not tolerate surgery were selected in our hospital from January 2012 to December ~2015. After admission, PTGD treatment was performed, and the related indexes before and after puncture were detected. Results 41 patients were successful puncture, puncture and drainage of 48 h and 72 h were white blood cells, bilirubin, alanine aminotransferase, visual analogue scale (VAS) were significantly decreased, the difference was statistically significant (P0.05), the size and thickness of gallbladder wall of gallbladder and common bile duct width was significantly reduced, with statistical significance the difference (P0.05). After the puncture, the drainage tube was blocked in L cases, the drainage tube slipped l cases, no bleeding and biliary fistula and other complications. After the puncture, 39 cases of further operation or ERCP treatment were cured, and 2 cases were discharged from the hospital. Conclusion PTGD is a minimally invasive, safe and reliable treatment for patients with severe acute and severe cholangitis with high risk of operation.
【作者单位】：中国人民解放军第97医院普通外科;中国人民解放军第97医院特诊科;
【分类号】：R657.45
【正文快照】： 州221004)急性重症胆管炎即急性梗阻性化脓性胆管炎(Acuteobstructive suppurative cholangitis,AOSC)是临床较为常见的急危重症之一,起病急、进展快、死亡率高的特点,死亡率一般在25%左右[1]。对发生感染性休克和多脏器功能衰竭的急危重症患者,死亡率更高。超声引导下经皮经

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