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对住院患者进行45天随访,比较有无止血剂情况下腹腔镜胆囊造瘘术的超声检查结果。

Comparison of the sonographic findings in laparoscopic cholecystostomy with and without hemostatic agent on 45-day follow-up of patients attending hospital.

作者信息

Mohammadifard Mahyar, Naseh Ghodratollah, Oskooi Rozita Khatamian, Sharifzadeh Gholamreza, Eshraghi Samira

机构信息

Department of Radiology, Birjand University of Medical Sciences, Birjand, Iran.

Department of Surgery, Birjand University of Medical Sciences, Birjand, Iran.

出版信息

J Family Med Prim Care. 2019 May;8(5):1678-1684. doi: 10.4103/jfmpc.jfmpc_92_19.

Abstract

INTRODUCTION

Cholelithiasis is one of the most prevalent pathological conditions, and elective laparoscopic cholecystostomy with and without hemostatic agent (HA) is the therapeutic approach to its treatment. This research study aimed to compare the sonographic findings of patients who underwent cholecystostomy with and without HA use.

MATERIALS AND METHODS

This cross-sectional, descriptive-analysis study was conducted by available nonprobability sampling technique, and according to Cochran Formula, 144 patients, who underwent laparoscopic cholecystostomy, were recruited and divided into two groups including a group of 85 patients with HA use and a group of 59 patients without HA use. Patients in each group had sonography on discharge date and 15, 30, and 45 days after the surgery. Data were collected and entered in SPSS-24 software; meanwhile, descriptive statistics was used to analyze Chi-square test, Fisher's exact test, and Friedman and Wilcoxon nonparametric test.

FINDINGS

The results of the study showed that the presence of echogenic mass with reverberation artifact (abscess mucosa) on 15- and 30-day follow-up sonography of patients, who underwent laparoscopic cholecystostomy, were significantly higher in patients with HA than in the group without HA ( < 0.05), and on 45-day follow-up sonography, there was no significant correlation regarding the presence of echogenic mass with reverberation artifact (abscess mucosa) and fluid in the two groups ( > 0.05). Besides, HA density significantly decreases in individuals over time ( < 0.05); however, there was no significant differences between HA reduction rate and gender ( > 0.05).

CONCLUSION

These findings might be the indication of HA agents' effect on surgical operations and their resemblance to abscess. Due to the possibility of temporary immune responses to HA, as an external object, it is necessary, in vital pathologies, to pay close attention to what differentiates the normal imaging appearance in follow-up sonography.

摘要

引言

胆结石是最常见的病理状况之一,选择性腹腔镜胆囊造口术无论是否使用止血剂(HA)都是其治疗方法。本研究旨在比较使用和未使用HA进行胆囊造口术患者的超声检查结果。

材料与方法

本横断面描述性分析研究采用便利抽样技术,根据 Cochr an公式,招募了144例行腹腔镜胆囊造口术的患者,并分为两组,一组85例使用HA,另一组59例未使用HA。每组患者在出院日期以及术后15天、30天和45天进行超声检查。收集数据并录入SPSS - 24软件;同时,使用描述性统计分析卡方检验、Fisher精确检验以及Friedman和Wilcoxon非参数检验。

研究结果

研究结果显示,在接受腹腔镜胆囊造口术患者的15天和30天随访超声检查中,有回声团伴混响伪像(脓肿黏膜)的情况在使用HA的患者中显著高于未使用HA的组(P<0.05),而在45天随访超声检查中,两组在有回声团伴混响伪像(脓肿黏膜)和积液方面无显著相关性(P>0.05)。此外,HA密度随时间显著降低(P<0.05);然而,HA降低率与性别之间无显著差异(P>0.05)。

结论

这些发现可能表明HA制剂对外科手术有影响且与脓肿相似。由于作为外部物体的HA可能引发临时免疫反应,在重大病理状况下,有必要密切关注随访超声检查中正常影像表现的差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2be/6559063/39a5140ea6b8/JFMPC-8-1678-g003.jpg

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