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超声引导下经皮经肝胆囊引流改善重症急性胆囊炎患者的预后。

Ultrasound-Guided Percutaneous Transhepatic Gallbladder Drainage Improves the Prognosis of Patients with Severe Acute Cholecystitis.

作者信息

Jin Xin, Jiang Yunshan, Tang Jiongjiong

机构信息

Department of Ultrasound Medicine, The Central Hospital of Yongzhou, Yongzhou, Hunan 425006, China.

出版信息

Evid Based Complement Alternat Med. 2022 Aug 29;2022:5045869. doi: 10.1155/2022/5045869. eCollection 2022.

Abstract

The aim of this study was to investigate the clinical efficacy of ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGD) for the treatment of severe acute cholecystitis (AC). The data of 40 patients diagnosed with severe AC at our hospital between August 2020 and June 2021 were retrieved and classified into a PTGD group, open cholecystostomy (OC) group, laparoscopic cholecystectomy (LC) group, and conventional conservative treatment (CT) group. Before treatment and on days 1, 3, 5, and 7 after treatment, their serum levels of alanine aminotransferase (ALT), alkaline phosphatase (ALP), aspartate aminotransferase (AST), total bilirubin (TBIL), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), white blood cell count (WBC), IL-2, IL-4, IL-6, IL-8, and cancer antigen 19-9 (CA19-9) were measured. Additionally, clinical manifestations such as body temperature and pain score were monitored before treatment and at 24, 48, and 72 hours after treatment. The recovery time and complications/adverse reactions were statistically analyzed, and the Kaplan-Meier survival curve was plotted. After treatment, compared with the other three groups, the PTGD group had a significant reduction in serum indicators, including WBC and inflammatory factors, recovery time, pain score, and complications, and benefitted from better treatment efficacy and higher survival rate. Thus, ultrasound-guided PTGD was found to be more effective in treating severe AC patients and was associated with improved patient prognoses.

摘要

本研究旨在探讨超声引导下经皮经肝胆囊引流术(PTGD)治疗重症急性胆囊炎(AC)的临床疗效。检索了2020年8月至2021年6月期间在我院确诊为重症AC的40例患者的数据,并将其分为PTGD组、开腹胆囊造瘘术(OC)组、腹腔镜胆囊切除术(LC)组和传统保守治疗(CT)组。在治疗前以及治疗后第1、3、5和7天,检测他们的血清丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、白细胞计数(WBC)、白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和癌抗原19-9(CA19-9)水平。此外,在治疗前以及治疗后24、48和72小时监测体温和疼痛评分等临床表现。对恢复时间和并发症/不良反应进行统计学分析,并绘制Kaplan-Meier生存曲线。治疗后,与其他三组相比,PTGD组的血清指标(包括WBC和炎症因子)、恢复时间、疼痛评分和并发症均显著降低,且治疗效果更好,生存率更高。因此,发现超声引导下PTGD治疗重症AC患者更有效,并与改善患者预后相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0fc/9444390/54b6f52cd0e5/ECAM2022-5045869.001.jpg

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