超声引导下经皮经肝穿刺胆囊置管引流术治疗急性胆源性胰腺炎

目的探讨超声引导下经皮肝穿刺胆囊置管引流术(PTGD)治疗急性胆源性胰腺炎(ABP)的临床应用价值。方法将40例自身条件不允许或主观不接受手术治疗的ABP患者随机分为2组,每组各20例,分别采用常规药物联合PTGD治疗(置管组)及单纯常规药物治疗(对照组)。进行统计学分析,比较两组患者临床资料及治疗效果的差异。并观察PTGD治疗的并发症情况。结果两组性别、年龄及修正Ranson评分≥3分的患者所占比例的差异均无统计学意义(P均0.05)。置管组腹痛缓解时间(55.10±8.25)h]、血清淀粉酶恢复时间(65.20±12.00)h]、平均住院时间(18.70±2.80)天]均较对照组(72.50±17.40)h、(100.60±25.00)h、(23.60±3.20)天]明显减少(P均0.01)。置管组20例中,2例术后出现胆瘘,余18例均未出现并发症。结论超声引导下PTGD可对胆道进行有效的减压,明显缩短ABP患者腹痛缓解时间、血清淀粉酶恢复时间及平均住院时间。

Ultrasound-guided percutaneous transhepatic gallbladder-catheterizing drainage in treatment of acute biliary pancreatitis

Objective To evaluate the clinical application value of ultrasound-guided percutaneous transhepatic gallbladdercatheterizing drainage (PTGD) in treatment of acute biliary pancreatitis (ABP). Methods Totally 40 ABP patients without conditions of surgery or unwilling to the surgery were randomly divided into two groups. There were 20 cases in treatment group underwent conventional drug treatment combined with PTGD and another 20 cases in control group underwent simplely conventional drug treatment. The statistical analysis was performed to compare the clinical data and the treatment effect of the two groups. And the complications of PTGD were observed. Results No statistical difference of the gender, the age and the ratio of patients with modified Ranson score more than 3 pionts was found between the two groups (all P>0.05). The time of abdominal pain relief was separately (55.10±8.25)h in treatment group and (72.50±17.40)h in control group. The time of serum amylase return to normal was separately (65.20±12.00)h in treatment group and (100.60±25.00)h in control group. The time of hospitalization was separately (18.70±2.80) days in treatment group and (23.60±3.20) days in control group. All of the three time parameters of treatment group were less than those of control group (all P<0.01). There were 2 cases of bile leakage in treatment group. No postoperative complication was found in the other patients. Conclusion Ultrasound-guided PTGD can be used in the treatment of ABP with the advantages of reducing the time of abdominal pain relief, the time of serum amylase return to normal and the time of hospitalization.