超声引导下经皮胆囊穿刺双管引流联合胆道镜治疗急性结石性胆囊炎高危患者

发布时间：2018-10-08 07:46

【摘要】：目的探讨超声引导下经皮胆囊穿刺双管引流联合胆道镜治疗急性结石性胆囊炎高危患者的可行性及应用价值。方法回顾性分析2012年6月~2013年12月急性结石性胆囊炎高危患者24例的临床资料。合并高血压6例,心绞痛4例,心力衰竭2例,急性心肌梗死介入术后1例,慢性阻塞性肺病5例,糖尿病5例,慢性肾功能衰竭1例。美国麻醉师协会(American Society of Anesthesiologists,ASA)分级,Ⅲ级11例,Ⅳ级13例。行超声引导下经皮经肝胆囊穿刺引流,抽尽胆汁,注入生理盐水使胆囊充盈,再于右侧肋缘下穿刺胆囊,双管引流,1周后扩张窦道,行胆道镜取石。结果所有患者穿刺引流后症状及体征缓解,均胆道镜取净胆囊结石,无胆漏、肠漏、出血等严重并发症发生。21例随访6~24个月,(11.1±6.1)月。1例胆囊结石复发。结论该方法治疗高危急性结石性胆囊炎患者安全有效,具有临床应用价值。
[Abstract]:Objective to explore the feasibility and application value of ultrasound guided percutaneous double-tube cholecystectomy combined with choledochoscope in the treatment of high risk patients with acute calculous cholecystitis. Methods the clinical data of 24 patients with acute calculous cholecystitis from June 2012 to December 2013 were retrospectively analyzed. There were 6 cases of hypertension, 4 cases of angina pectoris, 2 cases of heart failure, 1 case of acute myocardial infarction after interventional operation, 5 cases of chronic obstructive pulmonary disease, 5 cases of diabetes mellitus and 1 case of chronic renal failure. There were 11 cases of grade 鈪，

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