超声引导下经皮胆囊穿刺引流术对老年急性胆囊炎疗效分析.docVIP

超声引导下经皮胆囊穿刺引流术对老年急性胆囊炎疗效分析 　　[摘要] 目的 比较超声引导下经皮胆囊穿刺引流术和胆囊切除手术治疗老年急性胆囊炎的临床疗效。方法 选择2010年6月～2011年12月在我院行急性胆囊炎手术治疗的78例老年患者，按照其手术方式将所有患者分为穿刺术组39例和传统胆囊切除手术组39例，观察并比较两组患者的临床治疗效果。结果 穿刺引流组在导管留置时间、胃肠减压时间、抗生素治疗时间、住院时间和患者治疗满意度均显著优于手术切除组，且差异均具有显著统计学意义（P0.05）。穿刺引流组未发生严重并发症，切除术组39例中，7例切口出现液化、5例发生伤口感染、2例大出血，并发症的总发生率为40.9%（9/22），死亡3例。结论 超声引导下经皮胆囊穿刺引流术治疗老年急性胆囊炎患者安全可行，创伤小、恢复快、并发症少，可迅速控制病情，是治疗老年急性胆囊炎的有效方法。 　　[关键词] 超声；穿刺引流术；急性胆囊炎；老年 　　[中图分类号] R657.41 [文献标识码] B [文章编号] 2095-0616（2014）07-195-03 　　Analysis of efficacy of ultrasound-guided percutaneous gallbladder puncture and drainage surgery for elderly patients with acute cholecystitis 　　LI Henghua 　　North Shenzao County Health Center， Dongtai 224224，China 　　[Abstract] Objective To compare the clinical efficacy of the ultrasound-guided percutaneous gallbladder puncture and drainage surgery and the cholecystectomy for the elderly patients with acute cholecystitis. Methods Seventy-eight elderly patients with acute cholecystitis who received surgical treatment in our hospital from June 2010 to December 2011 were selected and divided into the puncture surgery group with 39 patients and the traditional cholecystectomy group with 39 patients according to the surgical method. The clinical efficacy of the two groups was observed and compared. Results The puncture and drainage surgery group was significantly better than the surgical resection group in the catheter indwelling time， gastrointestinal decompression time， antibiotic treatment time， length of hospital stay and patient treatment satisfaction， with statistically significant differences（P0.05）. In the puncture and drainage surgery group， no severe complications was observed； Of the 39 patients in the resection group， 7 patients had liquidation， 5 patients had wound infection and 2 patients had massive bleeding， with the total incidence of complications of 40.9%（9/22）， and 3 patients died. Conclusion In the treatment of elderly patients with acute cholecystitis， ultrasound-guided per