本文選題：急性化膿性膽囊炎 + 老年人��； 參考：《山東醫(yī)藥》2017年25期

【摘要】：目的觀察超聲引導(dǎo)下經(jīng)皮經(jīng)肝膽囊穿刺引流術(shù)(PTGD)聯(lián)合腹腔鏡下膽囊切除術(shù)(LC)序貫治療老年高危急性化膿性膽囊炎的效果。方法選取50例老年急性化膿性膽囊炎合并嚴(yán)重心肺功能障礙的患者,于超聲引導(dǎo)下PTGD聯(lián)合LC序貫治療,觀察患者的治療效果,比較患者術(shù)前及術(shù)后3、7 d體溫,血WBC,血生化指標(biāo)ALT、AST、血漿白蛋白、總膽紅素水平。ELISA法測定血清炎性因子IL-6、單向免疫擴(kuò)散法測定血清C反應(yīng)蛋白。結(jié)果PTGD術(shù)后3、7 d患者體溫與術(shù)前比較明顯降低,差異有統(tǒng)計(jì)學(xué)意義(P均0.05)。術(shù)后3、7 d患者WBC、ALT、AST、血漿白蛋白、總膽紅素、CRP水平與術(shù)前比較明顯降低,差異有統(tǒng)計(jì)學(xué)意義(P均0.05)。結(jié)論對于不能耐受急癥手術(shù)的老年危重化膿性膽囊炎患者,通過PTGD+LC序貫式療法能明顯提高治療效果。
[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.
【作者單位】： 天津市第五中心醫(yī)院;
【分類號】：R575.61

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