经皮经肝胆囊穿刺置管引流术联合腹腔镜胆囊切除术治疗老年急性胆囊炎患者的效果

目的：观察经皮经肝胆囊穿刺置管引流术（PTGD）联合腹腔镜胆囊切除术治疗老年急性胆囊炎患者的效果。方法：选取82例老年急性胆囊炎患者为研究对象，按随机数字表法分为研究组（n=41）和对照组（n=41）。对照组采用腹腔镜胆囊切除术治疗，研究组采用PTGD联合腹腔镜胆囊切除术治疗，比较两组围术期相关指标水平、胃肠功能恢复指标水平、疼痛程度[视觉模拟评分（VAS）]和并发症发生率。结果：研究组术中出血量少于对照组，手术时间、首次下床活动时间均短于对照组，差异有统计学意义（P<0.05）；研究组肛门排便时间、肛门排气时间、首次进食时间均短于对照组，差异有统计学意义（P<0.05）；术后1、3、6 d，研究组VAS评分均低于对照组，差异有统计学意义（P<0.05）；研究组并发症发生率为2.44%，低于对照组的19.51%，差异有统计学意义（P<0.05）。结论：PTGD联合腹腔镜胆囊切除术治疗老年急性胆囊炎患者可改善围术期相关指标水平，降低胃肠功能恢复指标水平、VAS评分和并发症发生率，其效果优于单纯腹腔镜胆囊切除术治疗。

Effects of percutaneous transhepatic gallbladder drainage combined with laparoscopic cholecystectomy in treatment of elderly patients with acute cholecystitis

Objective:To observe effects of percutaneous transhepatic gallbladder drainage(TGD)combined with laparoscopic cholecystectomy in treatment of elderly patients with acute cholecystitis.Methods:82 elderly patients with acute cholecystitis were selected as the research objects,and were divided into study group(n=41)and control group(n=41)according to the random number table method.The control group was treated with laparoscopic cholecystectomy,while the study group was treated with PTGD combined with laparoscopic cholecystectomy.The perioperative related index levels,the gastrointestinal function recovery index levels,the pain degree[visual analog scale(VAS)score]and the incidence of complications were compared between the two groups.Results:The intraoperative blood loss in the study group was less than that in the control group;the operation time and the first ambulation time were shorter than those in the control group;and the differences were statistically significant(P<0.05).The anal defecation time,the anal exhaust time,and the first eating time in the study group were shorter than those in the control group,and the differences were statistically significant(P<0.05).1,3,and 6 days after the surgery,the VAS scores of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the study group was 2.44%,which was lower than 19.51%in the control group,and the difference was statistically significant(P<0.05).Conclusions:PTGD combined with laparoscopic cholecystectomy in the treatment of the elderly patients with acute cholecystitis can improve the levels of perioperative related indexes,reduce the levels of gastrointestinal function recovery indexes,the VAS score and the incidence of complications.Moreover,it is superior to single laparoscopic cholecystectomy.