PTGBD穿刺引流与腹腔镜胆囊切除术联合治疗危重胆囊炎的临床疗效分析(1)
[摘要] 目的 分析PTGBD穿刺引流与腹腔镜胆囊切除术联合治疗危重胆囊炎的临床疗效。 方法 选取2013年1月—2014年12月间该院收治的危重胆囊炎患者共102例，根据手术方式不同分为PTGBD与LC联合组和急诊LC组。比较两组手术时间、手术出血量、腹腔引流量、腹腔引流引流时间、住院天数、费用、及患者满意度等。 结果 急诊LC组患者手术中出血量、腹腔引流时间以及肛门排气时间明显多于PTGDB联合LC组，差异有统计学意义(P<0.05)；急诊LC组患者并发症发生率远高于PTGDB联合LC组，且患者的满意率也明显低于PTGDB联合LC组，差异有统计学意义(P<0.05)。结论PTGBD联合LC术式是目前治疗危重胆囊炎最为有效的治疗手段，值得临床推广应用。
[关键词] 全腔镜；微创手术；腔镜辅助小切口技术；甲状腺
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2015)06(c)-0040-03
[Abstract] Objective To analyze the curative effect of PTGBD(Percutaneous Transhepatie Gallbladder Drainage) combined with LC(Laparoscopic Cholecystectomy) in the treatment of severe cholecystitis. Methods 102 patients with severe cholecystitis admitted to our hospital between January 2013 and December 2014 were divided into PTGBD combine with LC group and emergency LC group. The operation time， bleeding volume， amount of abdominal drainage， time of abdominal drainage，， hospitalization days， expenses and patient satisfaction of the two groups were compared. Results The operation bleeding， abdominal drainage time， anus exhaust time of the emergency LC group in were more than those of the PTGDB combined with LC group， and the differences were statistically significant (P < 0.05)； the incidence of complications of the emergency LC group was far higher than that of the PTGDB combined LC group， and the satisfaction rate of the patients in the emergency LC group was significantly lower than that in the PTGDB combined with LC group， and the differences were with statistical significance(P < 0.05). Conclusion PTGBD combined with LC surgery is currently the most effective treatment of severe cholecystitis treatment and it is worthy of clinical application.
[Key words] The full endoscopic； Minimally invasive operation； Endoscope assisted small incision technique； Thyroid
胆囊炎是发病率较高的常见疾病，常与胆石症合并存在，目前国内外治疗非急性胆囊炎的主要手术是腹腔镜胆囊切除术(Laparoscopic Cholecystectomy，LC)[1]。有很多报道表明，LC手术并不是完全适用于所以胆囊炎患者，对于急性胆囊炎，特别是合并胆石症以及其他严重内科疾病的患者，LC手术具有很大的局限性[2]。经肝胆囊穿刺引流术(Percutaneous Transhepatie Gallbladder Drainage，PTGBD)从1990年引入国内开始，为了治疗高风险的急性胆囊炎患者，越来越多地临床手术将其用于辅助LC，但医学上PTGBD辅助LC术式的应用效果是否远优于急诊LC手术仍然没有统一。为分析PTGBD穿刺引流与腹腔镜胆囊切除术联合治疗危重胆囊炎的临床疗效，现分析2013年1月—2014年12月间该院收治的危重胆囊炎患者102例的临床资料，现报道如下。
1 资料与方法
1.1 一般资料
选取该院收治的危重胆囊炎患者共102例，所有患者根据手术方式不同分为PTGBD与LC联合组和急诊LC组。急诊LC组共有患者56例，男36例，女20例，年龄为42～86岁，平均为(65.5±8.1)岁。PTGBD与LC联合组共有患者46例，男28例，女18例，年龄为43～84岁，平均(66.7±9.2)岁。两组患者在性别、年龄、病重程度等方面，差异无统计学意义(P>0.05)。纳入标准如下：①患者右上腹明显疼痛且墨菲氏呈阳性；②影像学显示患者胆囊显著增大且胆囊壁增厚并>3 mm；③患者体温达37 ℃以上。, 百拇医药(唐威 李劲东)
[关键词] 全腔镜；微创手术；腔镜辅助小切口技术；甲状腺
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2015)06(c)-0040-03
[Abstract] Objective To analyze the curative effect of PTGBD(Percutaneous Transhepatie Gallbladder Drainage) combined with LC(Laparoscopic Cholecystectomy) in the treatment of severe cholecystitis. Methods 102 patients with severe cholecystitis admitted to our hospital between January 2013 and December 2014 were divided into PTGBD combine with LC group and emergency LC group. The operation time， bleeding volume， amount of abdominal drainage， time of abdominal drainage，， hospitalization days， expenses and patient satisfaction of the two groups were compared. Results The operation bleeding， abdominal drainage time， anus exhaust time of the emergency LC group in were more than those of the PTGDB combined with LC group， and the differences were statistically significant (P < 0.05)； the incidence of complications of the emergency LC group was far higher than that of the PTGDB combined LC group， and the satisfaction rate of the patients in the emergency LC group was significantly lower than that in the PTGDB combined with LC group， and the differences were with statistical significance(P < 0.05). Conclusion PTGBD combined with LC surgery is currently the most effective treatment of severe cholecystitis treatment and it is worthy of clinical application.
[Key words] The full endoscopic； Minimally invasive operation； Endoscope assisted small incision technique； Thyroid
胆囊炎是发病率较高的常见疾病，常与胆石症合并存在，目前国内外治疗非急性胆囊炎的主要手术是腹腔镜胆囊切除术(Laparoscopic Cholecystectomy，LC)[1]。有很多报道表明，LC手术并不是完全适用于所以胆囊炎患者，对于急性胆囊炎，特别是合并胆石症以及其他严重内科疾病的患者，LC手术具有很大的局限性[2]。经肝胆囊穿刺引流术(Percutaneous Transhepatie Gallbladder Drainage，PTGBD)从1990年引入国内开始，为了治疗高风险的急性胆囊炎患者，越来越多地临床手术将其用于辅助LC，但医学上PTGBD辅助LC术式的应用效果是否远优于急诊LC手术仍然没有统一。为分析PTGBD穿刺引流与腹腔镜胆囊切除术联合治疗危重胆囊炎的临床疗效，现分析2013年1月—2014年12月间该院收治的危重胆囊炎患者102例的临床资料，现报道如下。
1 资料与方法
1.1 一般资料
选取该院收治的危重胆囊炎患者共102例，所有患者根据手术方式不同分为PTGBD与LC联合组和急诊LC组。急诊LC组共有患者56例，男36例，女20例，年龄为42～86岁，平均为(65.5±8.1)岁。PTGBD与LC联合组共有患者46例，男28例，女18例，年龄为43～84岁，平均(66.7±9.2)岁。两组患者在性别、年龄、病重程度等方面，差异无统计学意义(P>0.05)。纳入标准如下：①患者右上腹明显疼痛且墨菲氏呈阳性；②影像学显示患者胆囊显著增大且胆囊壁增厚并>3 mm；③患者体温达37 ℃以上。, 百拇医药(唐威 李劲东)