B超引导经皮经肝胆囊穿刺引流术在胆源性胰腺炎治疗中的临床意义

摘要

Objective:To explore the clinical significance of ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGBD) in the treatment of acute biliary pancreatitis.Methods:According to the inclusion and exclusion criteria, clinical data of 72 patients with acute biliary pancreatitis admitted were collected, among which 36 patients (research group) received PTGBD and 36 patients received conservative symptomatic treatment (control group).To observe the clinical treatment effect and the incidence of complications during the hospitalization of the two groups.Results:White blood cell count (WBC), c-reactive protein (CRP), serum amylase (AMS), serum lipase (LPS), ALT (ALT) and gallbladder size were significantly decreased in the study group compared with the control group, with statistically significant differences (P<0.05).The duration of abdominal pain relief, body temperature recovery and hospitalization in the study group was significantly lower than that in the control group, and the difference was statistically significant (P<0.05).The incidence of peritonitis, biliary fistula, SIRS, death, pancreatic abscess, and pseudocyst in the study group was statistically significant compared with the control group (P<0.05).Conclusion:In patients with acute biliary pancreatitis, the effect of symptomatic conservative treatment combined with PTGBD is significantly better than that of simple conservative treatment, especially for the rapid relief of early symptoms, and the incidence of short-term and long-term complications is significantly reduced.%目的:探讨利用超声引导下经皮经肝胆囊穿刺引流术 (PTGBD) 治疗急性胆源性胰腺炎的临床意义.方法:根据入选及排除标准, 收集72例急性胆源性胰腺炎患者的临床资料, 其中PTGBD治疗36例 (研究组), 保守对症治疗36例 (对照组), 观察两组患者住院期间临床治疗效果及并发症的发生率.结果:研究组患者在住院治疗期间白细胞计数 (WBC) 、C反应蛋白 (CRP) 、血清淀粉酶 (AMS) 、血清脂肪酶 (LPS) 、谷丙转氨酶 (ALT) 、胆囊大小, 与对照组相比明显降低, 差异具有统计学意义 (P<0.05) .研究组腹痛缓解时间、体温恢复时间、住院时长, 明显低于对照组, 差异具有统计学意义 (P<0.05) .研究组腹膜炎、胆瘘、全身炎症反应综合征 (SIRS) 、死亡、胰腺脓肿、胰腺假性囊肿发生率与对照组相比, 分别为 (8.3％与19.4％, 2.7％与11.1％, 8.3％与22.2％, 5.4％与13.8％, 2.9％与9.6％, 5.8％与12.9％), 差异具有统计学意义 (P<0.05) .结论:在急性胆源性胰腺炎患者中, 对症保守治疗联合PTGBD治疗效果明显优于单纯性保守治疗, 尤其对患者早期症状快速缓解疗效显著, 并且明显降低短期及长期并发症发生率.