CAJ | 학술논문

目的探讨经皮肝胆囊穿刺引流对择期行腹腔镜手术治疗高危结石性化脓性胆囊炎的影响。方法对近年来本院收治的急性结石性化脓性胆囊炎老年患者76例行腹腔镜胆囊切除术（LC）的临床资料进行回顾性分析。将患者分为 A组（入院后72 h内手术）和B组（经皮胆囊穿刺引流后保守治疗，再择期手术）。比较分析两组患者手术的并发症、中转开腹率及总有效率。结果 A、B两组术后并发症发生率分别为36．11％和15．00％，两组比较差异有统计学意义（P＜0．05）；A、B两组中转开腹率分别为13．89％和15．00％，A、B两组手术时间、中转开腹率比较差异无统计学意义（P＞0．05）；A组总有效率明显低于 B组，差异有统计学意义（P＜0．05）。结论经皮肝胆囊穿刺引流结合 LC对急性结石性化脓性胆囊炎的高危老年患者是一种更安全、有效的治疗方法。
목적탐토경피간담낭천자인류대택기행복강경수술치료고위결석성화농성담낭염적영향。방법대근년래본원수치적급성결석성화농성담낭염노년환자76례행복강경담낭절제술（LC）적림상자료진행회고성분석。장환자분위 A조（입원후72 h내수술）화B조（경피담낭천자인류후보수치료，재택기수술）。비교분석량조환자수술적병발증、중전개복솔급총유효솔。결과 A、B량조술후병발증발생솔분별위36．11％화15．00％，량조비교차이유통계학의의（P＜0．05）；A、B량조중전개복솔분별위13．89％화15．00％，A、B량조수술시간、중전개복솔비교차이무통계학의의（P＞0．05）；A조총유효솔명현저우 B조，차이유통계학의의（P＜0．05）。결론경피간담낭천자인류결합 LC대급성결석성화농성담낭염적고위노년환자시일충경안전、유효적치료방법。
Objective To investigated the percutaneous transhepatic gallbladder drainage combined laparoscopic cholecystectomy in the treatment of purulent cholecystolithiasis for serious patients.Methods Our hospital in the past two years,76 underwent lap-aroscopic cholecystectomy in the acute calculous suppurative cholecystitis of elderly patients with clinical data were retrospectively analyzed.Patients could be divided into group A(surgery)within 72 hours after admission,group B(conservative treatment after percutaneous puncture drainage of the gallbladder,again)elective surgical procedures,A total of 2 groups.Comparative analysis of two groups of patients with complications of surgery,laparotomy rate and total effective rate.Results A,B two groups of postoper-ative complication rates were 36.11% and 15.00% respectively,each postoperative complication rates had significant difference(P<0.05);A,B two groups of transit open rate was 13.89% and 15.00%,A,B two groups of operation time,transit open rate had no significant difference(P>0.05),the total effective rate was lower than that in group B,group A statistically significant differ-ence(P<0.05).Conclusion PTGD combined LC is simple and effective treatment in high-risk acute purulent cholecystolithiasis.