【摘要】：目的探討超聲引導下經(jīng)皮膽囊穿刺雙管引流聯(lián)合膽道鏡治療急性結(jié)石性膽囊炎高危患者的可行性及應用價值。方法回顧性分析2012年6月~2013年12月急性結(jié)石性膽囊炎高�；颊�24例的臨床資料。合并高血壓6例,心絞痛4例,心力衰竭2例,急性心肌梗死介入術后1例,慢性阻塞性肺病5例,糖尿病5例,慢性腎功能衰竭1例。美國麻醉師協(xié)會(American Society of Anesthesiologists,ASA)分級,Ⅲ級11例,Ⅳ級13例。行超聲引導下經(jīng)皮經(jīng)肝膽囊穿刺引流,抽盡膽汁,注入生理鹽水使膽囊充盈,再于右側(cè)肋緣下穿刺膽囊,雙管引流,1周后擴張竇道,行膽道鏡取石。結(jié)果所有患者穿刺引流后癥狀及體征緩解,均膽道鏡取凈膽囊結(jié)石,無膽漏、腸漏、出血等嚴重并發(fā)癥發(fā)生。21例隨訪6~24個月,(11.1±6.1)月。1例膽囊結(jié)石復發(fā)。結(jié)論該方法治療高危急性結(jié)石性膽囊炎患者安全有效,具有臨床應用價值。
[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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