经皮经肝胆囊穿刺引流术治疗高危急性胆囊炎的疗效观察

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1、经皮经肝胆囊穿刺引流术治疗高危急性胆囊炎的疗效观察邱明'，吴向未'，杨宏强2,张示杰21.石河子人学医学院硕士研究生2.石河子人学医学院附屈医院，新疆石河子，832000【摘要】目的探讨高危急性胆囊炎患者行经皮经肝胆囊穿刺引流术(perculaneoustranshepaticgallbladderdrainage,PTGD)的疗效。方法冋顾性分析我院2005年1月至2013年6月接受PTGD治疗的116例急性胆囊炎患者的临床资料。结果116例患者均成功行PTGD,治疗后，症状、实验室检查在较短时间内

2、有明显改善。胆汁培养47例培养出阳性结果，其屮大肠埃希菌29例。经随访，3例因胆囊炎反复发作直接行开腹手术，113例获得有效的胆囊引流。26例于PTGD拔管后未行进一步治疗，至随访时未再次出现任何症状。77例于PTGD后行择期胆囊切除术,6例伴有胆总管结石患者于PTGD拔管后行经内镜逆行性胰胆管造影术(EncoscopicRetrogradeCholangio-Pancreatography,ERCP)后治愈。4例因年龄大，心肺功能不全等未行进一步治疗而长期带管。全组无因PTGD引起的并发症死亡的病例

3、。结论PTGD是一种安全、有效的治疗方法，其成功率高、并发症少，可迅速缓解患者病情，为进一步的腹腔镜胆囊切除治疗提供了机会。【关键词】急性胆囊炎；经皮经肝胆囊穿刺引流术TheefficacyofPTGDtreatmenttohigh-riskacutecholecystitispatientsQIUMinJ,WUXiang-wei2,YANGHong-qiang,ZHANGShi-jie・1.Themedicalcollegeofshiheziuniversityfsliihezi832000.Chi

4、na.2.DepartmentofHepatobiliarySurgery,thefirstaffilicatedofthemedicalcollegeofshiheziuniversity,,shihezi832000fChina.【Abstract]ObjectiveToinvestigatetheefficacyofhigh・riskpatientswithacutecholecystitisbyultrasound-guidedpercutaneoustranshepaticgallbladd

5、erdrainage(PTGD).MethodsClinicaldataof116casesofacutecholecystitispatientswithhigh-riskwhoundenventPTGDtreatmentinJanuary2005〜June2013ofourhospitalwereanalyzedretrospectivelyResultsPTGDwassuccessfullyperformedinallpatients.symptomsandlaboratoryresultsaf

6、tertreatmenthadasignificantimprovementinashorttime.Atotalof47bacterialstrainswereisolatedduringthesurveyperiod,whichincluded29Escherichiacoli・3patientsconvertedtoopensurgerybecauseofrecurrentacutecholecystitis.Gallbladderdrainagewaseffectivein113patient

7、s,26patientswerecured.Selectivecholecystcetomywasperformedin77cases.6patientswithcholedocholithiasiswerecuredbyERCPafterExtubation.4elderlypatientswithcardiopulmonarydysfunctiondidnotundergofurthertreatment.NopatientsdiedofthecomplicationsofPTGD.Conclus

8、ionPTGDisasafeandaneffectivetreatment,thetechniquecanobviouslyalleviatethepatient'scondition,reducetheincidenceofcomplication.providedtheopportunityforfurtherLCtreatment.[keyword]acutecholecystitis；PTGD急性胆囊炎是胆囊梗阻和细菌感染引起的胆囊炎症，是普外科