PTGD联合腹腔镜下LC序贯治疗老年危重化脓性胆囊炎50例效果观察

发布时间：2018-06-18 16:03

本文选题：急性化脓性胆囊炎 + 老年人　；参考：《山东医药》2017年25期

【摘要】：目的观察超声引导下经皮经肝胆囊穿刺引流术(PTGD)联合腹腔镜下胆囊切除术(LC)序贯治疗老年高危急性化脓性胆囊炎的效果。方法选取50例老年急性化脓性胆囊炎合并严重心肺功能障碍的患者,于超声引导下PTGD联合LC序贯治疗,观察患者的治疗效果,比较患者术前及术后3、7 d体温,血WBC,血生化指标ALT、AST、血浆白蛋白、总胆红素水平。ELISA法测定血清炎性因子IL-6、单向免疫扩散法测定血清C反应蛋白。结果PTGD术后3、7 d患者体温与术前比较明显降低,差异有统计学意义(P均0.05)。术后3、7 d患者WBC、ALT、AST、血浆白蛋白、总胆红素、CRP水平与术前比较明显降低,差异有统计学意义(P均0.05)。结论对于不能耐受急症手术的老年危重化脓性胆囊炎患者,通过PTGD+LC序贯式疗法能明显提高治疗效果。
[Abstract]:Objective to observe the effect of percutaneous transhepatic cholecystectomy (PTGD) combined with laparoscopic cholecystectomy (LC) in the treatment of acute suppurative cholecystitis. Methods 50 elderly patients with acute suppurative cholecystitis complicated with severe cardiopulmonary dysfunction were treated with PTGD combined with LC under the guidance of ultrasound. Serum WBC, serum alt AST, plasma albumin, total bilirubin level. Elisa method were used to detect serum inflammatory factor IL-6, and one-way immunodiffusion method to detect serum C-reactive protein. Results the body temperature of patients with PTGD 3 days after PTGD was significantly lower than that before PTGD, and the difference was statistically significant (P < 0.05). The levels of serum albumin, total bilirubin and CRP in patients with WBC and ALT were significantly lower than those before operation on the 7th day after operation, and the difference was statistically significant (P < 0.05). Conclusion for the elderly patients with severe suppurative cholecystitis who can not tolerate emergency surgery, sequential PTGD LC therapy can significantly improve the therapeutic effect.
【作者单位】：天津市第五中心医院;
【分类号】：R575.61

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