回顾性分析经皮经肝胆囊穿刺引流治疗高危急性胆囊炎患者疗效

目的:了解经皮经肝胆囊穿刺引流(PTGBD)治疗高危急性胆囊炎患者的临床疗效.方法:回顾性分析217例高危急性胆囊炎患者的临床资料,其中急诊行开腹或腹腔镜胆囊切除手术治疗125例(对照组),PTGBD治疗92例(治疗组),观察两组间治疗效果.结果:对照组术后并发胆漏2例、胆管炎3例、肝周积液1例、不完全性肠梗阻1例、2例胆囊床渗血,伤口脂肪液化延迟愈合6例,死亡4例.治疗组92例均穿刺置管成功,术后24～72 h内腹痛缓解,体温降至正常,并发1例胆漏,2例侧孔堵塞,1例引流管脱出;死亡2例.与对照组相比并发症发生率具有统计学意义(P <0.05).结论:对于高危急性胆囊炎患者,经皮经肝胆囊穿刺引流术和急诊胆囊手术都是有效的治疗措施,PTGD简便、安全、有效,减少并发症发生率.

Retrospective Analysis of the Efficacy about Percutaneous Transhepatic Gallbladder Drainage for the Treatment of High-Risk Acute Cholecystitis Patients

Objective To realize the clinical efficacy of percutaneous transhepatic gallbladder drainage for the treatment of high-risk acute cholecystitis patients.Methods The clinical data of 217 patients of high-risk acute cholecystitis patients were analyzed retrospectively.The control group included 125 cases undergoing emergency cholecystectomy by open or laparoscopic approach and the treatment group included 92 cases treated with PTGBD.observe the efficacy between the two groups.Results the complications of the control group after operation included:2 cases with biliary leak,3 with cholangitis,1 with hepatie around effusion,1 cases with incomplete intestinal obstruction and 2 patients bleeding from the gallbladder bed.6 patients with delayed healing because of the wound fat liquefaction.Of the 4 died cases.the treatment group was successfully performed in 92 cases.The abdominal pains relived after 24～72 hours and the temperature returned to normal.The complications included:1 cases with biliary leak,2 with lateral holes blocked and the dislodgement of drainage tube 1occured in 1 patient.Of the 2 died cases.Which compared with the complications of the control group were statistically significant(P < 0.05).Conclusion PTGBD and emergency cholocystectomy are highly efficient in resolving acute cholecystitis in high-risk patients.PTGBD is a simple,a safe,an effective and reduce the incidence of the complications.