CAJ | 학술논문

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（P＜0.05）。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。
목적：비교초성인도하경피담낭천자인류술화담낭절제수술치료노년급성담낭염적림상료효。방법선택2010년6월～2011년12월재아원행급성담낭염수술치료적78례노년환자，안조기수술방식장소유환자분위천자술조39례화전통담낭절제수술조39례，관찰병비교량조환자적림상치료효과。결과천자인류조재도관류치시간、위장감압시간、항생소치료시간、주원시간화환자치료만의도균현저우우수술절제조，차차이균구유현저통계학의의（P＜0.05）。천자인류조미발생엄중병발증，절제술조39례중，7례절구출현액화、5례발생상구감염、2례대출혈，병발증적총발생솔위40.9％（9/22），사망3례。결론초성인도하경피담낭천자인류술치료노년급성담낭염환자안전가행，창상소、회복쾌、병발증소，가신속공제병정，시치료노년급성담낭염적유효방법。
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(P<0.05). 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 percutaneous gallbladder puncture and drainage surgery is safe and feasible, causes small trauma and complications, enables fast recovery and can control the disease rapidly, thus is an effective method to treat elderly acute cholecystitis.