本文選題：經(jīng)皮肝膽囊穿刺引流術(shù)　切入點：腹腔鏡膽囊切除手術(shù)　出處：《中華醫(yī)院感染學(xué)雜志》2017年11期 　論文類型：期刊論文

【摘要】：目的探討經(jīng)皮肝膽囊穿刺引流術(shù)(PTGBD)聯(lián)合腹腔鏡膽囊切除手術(shù)(LC)治療高危急性膽囊炎患者的臨床效果。方法選取2013年1月-2016年4月在解放軍總醫(yī)院肝膽外科手術(shù)治療147例急性危重膽囊炎患者進(jìn)行回顧性分析,根據(jù)患者LC術(shù)前是否接受PTGBD治療分為聯(lián)合組71例、LC組76例,對比兩組患者的圍手術(shù)期指標(biāo)、術(shù)后實驗室指標(biāo)的差異。結(jié)果聯(lián)合組術(shù)中失血(80.3±18.2)ml、腹腔引流時間(3.5±1.2)d、進(jìn)食時間(3.0±1.1)d均顯著的低于LC組(116.4±24.6)ml、(4.3±1.5)d、(4.2±1.5)d,差異均有統(tǒng)計學(xué)意義(P0.05);兩組患者手術(shù)時間、術(shù)后住院時間比較差異無統(tǒng)計學(xué)意義;聯(lián)合組和LC組患者治療前的體溫、WBC計數(shù)、血清堿性磷酸酶(ALP)、總膽紅素(TBIL)、視覺模擬疼痛評分(VAS)差異均無統(tǒng)計學(xué)意義;術(shù)后72h,聯(lián)合組白細(xì)胞計數(shù)(6.4±1.7)109/L、血清ALP(98.3±11.2)U/L、TBIL(22.7±7.1)μmol/L、VAS評分(1.6±0.8)分均顯著低于LC組患者(8.9±2.5)109/L、(113.8±15.0)U/L、(27.0±8.3)μmol/L、(2.3±1.0)分,差異均有統(tǒng)計學(xué)意義(P0.05);聯(lián)合組和LC組患者肺部感染率、切口感染率、中轉(zhuǎn)開腹率比較差異無統(tǒng)計學(xué)意義。結(jié)論 PTGBD聯(lián)合LC治療高危急性膽囊炎患者較單純的LC手術(shù)更有利于患者術(shù)后恢復(fù)。
[Abstract]:Objective to investigate the clinical effect of percutaneous transhepatic cholecystectomy (PTGBD) combined with laparoscopic cholecystectomy (LC) in the treatment of high risk acute cholecystitis. A retrospective analysis of 147 patients with acute severe cholecystitis was made. According to whether or not the patients received PTGBD before LC, they were divided into two groups: the combined group (71 cases) and the LC group (76 cases). The perioperative indexes of the two groups were compared. Results the blood loss, abdominal drainage time and feeding time in the combined group were significantly lower than those in the LC group (116.4 鹵24.6ml, 4.3 鹵1.5d, 4.2 鹵1.5g / d, P < 0.05), and the time of abdominal drainage was 3.5 鹵1.2g / d, and the feeding time was 3.0 鹵1.1g / d, respectively, which was significantly lower than that in the LC group (4.2 鹵1.5g / d), and the operative time of the two groups was significantly lower than that of the LC group (P < 0.05). There was no significant difference in postoperative hospitalization time, WBC count, serum alkaline phosphatase, total bilirubin TBILN and visual analogue pain score (VASs) in patients with combined group and LC group before treatment. At 72 hours after operation, the white blood cell count of the combined group was significantly lower than that in the LC group (6.4 鹵1.7 鹵1.7 鹵109 / L, ALP(98.3 鹵11.2U / L / L = 22.7 鹵7.1) 渭 mol / L / L and 1.6 鹵0.8), respectively, which was significantly lower than that in the LC group (113.8 鹵2.5109L / L + 15.0U / L = 27.0 鹵8.3u mol / L = 2.3 鹵1.0), and the lung infection rate, incision infection rate, incision infection rate in the combined group and LC group were significantly lower than those in the LC group (27.0 鹵8.3 渭 mol / L = 2.3 鹵1.0), and the lung infection rate, incision infection rate, incision infection rate in the combined group and LC group were significantly lower than those in the LC group. Conclusion PTGBD combined with LC is more beneficial to postoperative recovery in patients with high risk acute cholecystitis than LC alone.
【作者單位】： 解放軍總醫(yī)院急診科;勝利油田中心醫(yī)院急診科;麻城市人民醫(yī)院肝膽外科;
【分類號】：R657.4

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 王雪原;楊樹源;黃楹;孫梅;趙蕾;卓杰;高滿;;穿刺引流術(shù)對腦出血后腦水腫及預(yù)后的影響[J];中國現(xiàn)代神經(jīng)疾病雜志;2011年02期

2 陸扣虎,黃長銘,王海秋;腦膿腫引流術(shù)45例療效評價[J];蘇州醫(yī)學(xué)院學(xué)報;1997年03期

3 馬凌波;宋萊殷;李尚陽;許東紹;;穿刺引流術(shù)治療外傷性硬膜下積液21例臨床分析[J];微創(chuàng)醫(yī)學(xué);2009年03期

4 李東升,李玉輝,雷國亮,張建雷,楊炯達(dá);微創(chuàng)鉆孔穿刺引流術(shù)治療慢性硬腦膜下血腫[J];中國臨床神經(jīng)外科雜志;2003年03期

5 孫松濤;楊玉萍;趙佳林;;高血壓腦出血穿刺引流術(shù)59例分析[J];中國誤診學(xué)雜志;2009年10期

6 翟秀云,左君,魯秀國,周世聰,王家寶,周賢文;微創(chuàng)硬通道穿刺引流術(shù)在重型創(chuàng)傷性硬膜外血腫中的應(yīng)用價值[J];實用心腦肺血管病雜志;2005年05期

7 陸進(jìn)江;蘭偉;;邊疆縣醫(yī)院穿刺引流術(shù)治療高血壓性腦出血56例[J];中國社區(qū)醫(yī)師(醫(yī)學(xué)專業(yè));2011年24期

8 季雪亮;隋巖永;郭克光;;穿刺引流術(shù)治療基底節(jié)血腫臨床分析[J];中國當(dāng)代醫(yī)藥;2010年16期

9 李得祥;;顱骨鉆孔穿刺引流術(shù)治療高血壓性腦出血30例臨床分析[J];中國實用神經(jīng)疾病雜志;2012年12期

10 崔愛勤 ,李揚(yáng)波 ,陳玉平 ,劉玉璽 ,徐家立;超早期穿刺引流術(shù)治療高血壓性腦出血[J];中國微創(chuàng)外科雜志;2004年04期

相關(guān)會議論文 前1條

1 林兆奮;張悅柯;張連東;鄭志群;吳立鋒;王小東;宋啟京;楊興易;;無創(chuàng)定位穿刺引流術(shù)治療出血性腦中風(fēng)——附627例病例分析[A];《中華急診醫(yī)學(xué)雜志社》第三屆組稿會暨急診醫(yī)學(xué)學(xué)術(shù)研討會論文匯編[C];2004年

相關(guān)碩士學(xué)位論文 前1條

1 石罡;小骨瓣血腫清除術(shù)與穿刺引流術(shù)治療高血壓腦出血meta分析[D];昆明醫(yī)科大學(xué);2015年

，

本文編號：1605617