Ｂ超引导下经皮胆囊穿刺置管引流术治疗妊娠中晚期急性结石性胆囊炎

目的:探讨超声引导下经皮胆囊穿刺引流术(PPDG)治疗妊娠中晚期急性结石性胆囊炎的疗效。方法:回顾性分析2010年9月—2015年10月47例妊娠中晚期急性结石性胆囊炎患者行超声引导下PPDG的临床资料。结果:47例患者均成功实施PPDG,治疗后腹痛、发热等症状迅速缓解,无出血、胆瘘等并发症,实验室指标包括白细胞计数、转氨酶、总胆红素、降钙素原均较治疗前明显改善(均P0.05)。除1例患者置管后7 d导管脱落,其余患者均常规拔管或带管分娩后择期行胆囊切除术时拔管。47例患者28例自然分娩,19例剖宫产,新生儿均正常。结论:超声引导下PPDG是治疗妊娠中晚期急性结石胆囊炎有效、安全和简便的方法,推荐临床应用。

B-ultrasound guided percutaneous puncture and drainage of gallbladder for acute calculous cholecystitis during middle and late pregnancy

Objective: To evaluate the clinical efficacy of ultrasound guided percutaneous puncture and drainage of the gallbladder (PPDG) in treatment of acute calculous cholecystitis during middle and late pregnancy. Methods: The clinical data of 47 women with acute calculous cholecystitis during middle or late pregnancy undergoing ultrasound guided PPDG from September 2010 to October 2015 were retrospectively analyzed. Results: PPDG was successfully performed in all the 47 patients. After treatment, the symptoms such as abdominal pain and fever were relieved quickly, no complications such as hemorrhage or biliary fistula occurred, and the laboratory parameters that included white blood cell count, and transaminase, total bilirubin and procalcitonin levels were statistically improved compared with preoperative findings (all P<0.05). Except in one patient whose tube fell out at 7 days after tube placement, all the remaining patients underwent regular tube removal or had tube removal during elective surgery after delivery. Of the 47 patients, 28 cases had spontaneous labor, and 19 had caesarean section, and all the neonates were physically normal at birth. Conclusion: Ultrasound guided PPDG is an effective, safe and convenient method of treatment for acute calculous cholecystitis during middle and late pregnancy, and it is recommended to be used in clinical practice.