PTGBD联合LC对高龄急性胆囊炎合并糖尿病的疗效分析

目的 探讨经皮经肝胆囊穿刺引流(PTGBD)联合腹腔镜胆囊切除术(LC)对高龄急性胆囊炎合并糖尿病患者的疗效。方法 本回顾性研究以44例高龄急性胆囊炎合并糖尿病患者为研究对象，根据LC术前接受的治疗情况不同分为研究组(PTGBD组，n=20)和对照组(保守治疗组，n=24)。比较两组患者术中、术后各项指标的变化情况和并发症发生率。结果 研究组平均手术时间[(52.78±6.65)min vs(72.56±10.63)min]、术中出血量[(12.10±2.77)mL vs (18.52±2.47)mL]和术后住院时间[(5.85±0.75)d vs (8.91±1.09)d]均少于对照组(P<0.05)，研究组首次排气时间[(20.33±2.99)h vs (28.27±4.38)h]及早期下床活动时间[(28.66±3.29)h vs (39.31±4.33)h]均早于对照组(P<0.05)。两组患者术后1 d的WBC、CRP、VAS评分差异没有统计学意义，但术后3 d两组WBC[(5.84±1.01)×10⁹/L vs (6.72±0.67)×10...

Efficacy of percutaneous transhepatic gallbladder drainage combined with laparoscopic cholecystectomy for elderly patients with acute cholecystitis and diabetes mellitus

Objective To explore the curative effect of percutaneous transhepatic gallbladder drainage (PTGBD) combined with laparoscopic cholecystectomy (LC) for elderly patients with acute cholecystitis and diabetes mellitus. Methods A total of 44 elderly patients with acute cholecystitis and diabetes mellitus were retrospectively analyzed. According to the different treatment schemes before LC, patients were divided into study group (with PTGBD treatment, n=20) and control group (with conservative treatment, n=24). The changes of intraoperative and postoperative indicators and the incidence of complications were compared between the two groups.Results In the study group, the average operation time [(52.78±6.65)min vs (72.56±10.63)min], intraoperative blood loss [(12.10±2.77)mL vs (18.52±2.47)mL] and postoperative hospitalization time [(5.85±0.75)d vs(8.91±1.09)d] were significantly shorter than those in the control group (P<0.05); and the first exhaust time [(20.33±2.99)h vs (28.27±4.38)h], the early ambulation time [(28.66±3.29)h vs (39.31±4.33)h] were earlier than those in the control group (all P<0.05). There was no significant difference in WBC, CRP or VAS score between the two groups on day 1 postoperative, but the WBC, CRP and VAS score in both groups decreased on day 3 postoperative. For study group, WBC [(5.84±1.01)×10⁹ /L vs (6.72±0.67)×10⁹ /L], CRP [(8.47±2.20)mg/dL vs(15.29±3.04)mg/dL] and VAS score [(3.00±0.36)points vs (4.45±0.67)points] were all significantly lower than those in control group (P<0.05).The FBG and HbAlc on day 1 postoperative in both groups were lower than those preoperative. For study group, FBG [(7.33±0.26)mmol/L vs (8.09±0.47)mmol/L] and HbAlc [(6.06±0.25)% vs(6.68±0.51)%] were all significantly lower than those in control group (P<0.05). For both groups, there was no significant difference in FBG day 3 postoperative, and there was no significant difference in rates of postoperative complications incidence. Conclusion Treatment of PTGBD combined with LC is effective in elderly patients with acute cholecystitis and diabetes, which is beneficial for patients in postoperative recovery and long-term blood glucose control.