学术论文

      超声引导下胆囊穿刺引流术治疗老年人急性重症胆囊炎的临床效果观察

      Observation of the clinical effect of gallbladder puncture and drainage guided by ultrasound in the treatment of elderly patients with acute severe cholecystitis

      摘要:
      目的:探讨超声引导下胆囊穿刺引流术对老年人急性重症胆囊炎的治疗效果。方法选取老年急性重症胆囊炎患者71例,均采用超声引导下胆囊穿刺引流术治疗,对比术前和术后患者体征,记录置管成功率、炎症控制率、并发症及择期胆囊切除例数。结果急性非结石性胆囊炎组和急性结石性胆囊炎组的置管成功率均为100.00%;急性非结石性胆囊炎组的炎症控制率为97.29%,急性结石性胆囊炎组的炎症控制率为97.05%,差异无统计学意义(χ2=0.004,P =0.952),平均炎症控制率为97.18%。急性非结石性胆囊炎组无择期胆囊切除患者,急性结石性胆囊炎组有10例择期胆囊切除,差异有统计学意义(χ2=10.086,P =0.001);急性非结石性胆囊炎组无并发症,急性结石性胆囊炎组2例出血,差异无统计学意义(χ2=2.240, P =0.135)。结论超声引导下胆囊穿刺引流术能迅速缓解临床症状,提高手术成功率,降低临床风险,为老年人急性重症胆囊炎的优先治疗手段,值得在临床中推广。
      Abstract:
      Objective To study the effect of gallbladder puncture and drainage guided by ultrasound in the treatment of elderly patients with acute severe cholecystitis.Methods 71 elderly patients with acute severe cholecys-titis were selected.All patients were treated with gallbladder puncture and drainage guided by ultrasound.The preoper-ative and postoperative signs were compared.The success rate of the tube,the rate of inflammation control,the number of patients with disease onset and selective cholecystectomy were recorded.Results The success rate of intubation of the acute non -calculous cholecystitis group and acute calculous cholecystitis group was 100.00%.The inflammatory control rate of acute non -calculous cholecystitis group was 97.29%,which of the acute calculous cholecystitis group was 97.05%,the difference was not statistically significant(χ2 =0.004,P =0.952).The average control rate of inflammation was 97.18%.The acute non -calculous cholecystitis group had no elective cholecystectomy,and the acute calculous cholecystitis group had 10 patients undergoing elective cholecystectomy,there was significant differ-ence(χ2 =10.086,P =0.001).The acute non -calculous cholecystitis group had no complications,the acute calcu-lous cholecystitis group had 2 cases of bleeding,but the difference was not statistically significant(χ2 =2.240,P =0.135).Conclusion Gallbladder puncture and drainage guided by ultrasound can quickly relieve clinical symp-toms,improve the success rate of surgery and reduce the clinical risk for the elderly with acute severe cholecystitis,it is a clinical priority and worth to be promoted in clinical.
      作者: 王小龙
      Author: Wang Xiaolong
      作者单位: 台州市第一人民医院普外科, 浙江省台州,318020
      刊 名: 中国基层医药 ISTIC
      年,卷(期): 2017, 24(6)
      在线出版日期: 2017年3月29日