危重症患者并发急性非结石胆囊炎经床旁超声引导置管引流的疗效观察

目的探讨超声引导下胆囊穿刺置管引流术治疗危重症患者并发急性非结石胆囊炎的临床价值。方法对57例并发急性非结石性胆囊炎的危重患者,行床旁超声引导下经皮经肝胆囊穿刺引流术,观察胆囊穿刺引流前后患者临床症状、体征及血白细胞计数的变化情况。结果所有患者胆囊穿刺置管引流均获得成功,在术后24 h临床症状缓解。最终4例死亡,7例行手术治疗。结论床旁超声引导下经皮经肝胆囊穿刺引流术对于治疗危重症患者的急性非结石性胆囊炎是安全、有效的应急措施。

Observation on the Therapeutic Effect of Treatment of Acute Acalculous Cholecystitis with Percutaneous Transhepatic Gallbladder Drainage Guided by Bedside Ultrasound in Critical Patients

Objective To investigate the clinical value of percutaneous transhepatic gallbladder drainage guided by bedside ultrasound for treatment of acute acalculous cholecystitis in critical patients.Methods Under the guidance of bedside ultrasound,57 cases of critical patients complicated with acute acalculous cholecystitis underwent percutaneous transhepatic gallbladder drainage.The change of clinical symptoms,signs,and leukocyte count were observed.Results The operations were successfully accomplished in all patients,and clinical symptoms were alleviated 24 hours later.7 patients received cholecystectomy,and 4 patients died of associated complication finally.Conclusion The application of percutaneous transhepatic gallbladder drainage guided by bedside ultrasound is not only safe but also effective emergency treatment of acute acalculous cholecystitis in critical patients.