经皮经肝胆囊穿刺引流治疗高龄高危急性胆囊炎临床分析

目的探讨高龄、高危急性胆囊炎患者,给予经皮经肝胆囊穿刺引流（percuteaneous transhepaticgallbladder drainage,PTGD）的治疗价值。方法在B超引导下,对38例高龄、高危急性胆囊炎实行PTGD治疗。结果所有患者均在穿刺引流术后24～48 h内腹痛缓解,体温降至正常。术后10～12 d经引流管行胆管造影,对胆管通畅的病人于术后12～16 d拔管出院。未出现穿刺相关的并发症,其中23例于病情稳定后3～6个月行择期胆囊切除术。结论PTGD治疗高龄、高危急性胆囊炎,可以迅速缓解症状、控制感染,避免急诊手术引起的手术并发症,是一项安全、有效、简便的方法,值得推广。

The Analysis of PTGD Treatment in Acute Cholecystitis about Elderly and Highrisk Patients

Objective To study the treatment application of percutaneous transhepatic gallbladder drainage(PTGD) in acute cholecystitis with elderly and highrisk patients.Methods The PTGD treatment of 38 cases elderly and highrisk patients acute cholecystitis by ultrasonography.Results The pain in the abdomen of the patients was relieved within 24～48 hours and the temperature declined to the normal.Dranage tube cholangiography was operated within 10～12 days afteroperation and the tube would be pulled out to the easy and smooth cystic duct after 12～16 days without complications.The part of 23 cases were treated by selective cholecystcetomyin 3～6 months when desease plateau reached.Conclusion Symptom,clinical signs and infection of acute cholecystitis in elderly and highrisk patients can be controlled rapidly with PTGD without the operative complication by emergency operation.PTGD was a safe,simple and effetive procedure at present and in the future.