经皮经肝胆囊穿刺置管引流术治疗胆结石对血清WBC和TBIL的影响

摘要/Abstract

摘要： 目的探讨经皮经肝胆囊穿刺置管引流术治疗胆结石对血清总胆红素（total bilirubin,TBIL）与白细胞计数（White blood cell,WBC）的影响。方法选择2020年1月—2022年5月在郑州市中医院诊治的204例胆结石患者作为研究对象,根据1∶1奇偶分组原则把患者分为试验组和对照组,每组102例。对照组患者给予腹腔镜下手术治疗,试验组患者给予经皮经肝胆囊穿刺置管引流术治疗,比较两组患者术后恢复情况、术后并发症发生率、总体治疗效果及血清白细胞计数和总胆红素表达变化情况。结果试验组的术后肛门排气时间、术后进食固体食物时间、术后排便时间与术后住院时间都显著短于对照组,差异有统计学意义（P<0.05）。试验组术后7 d的切口愈合不良、腹腔感染、胆瘘、胆管损伤、穿孔等并发症发生率明显低于对照组,差异有统计学意义（P<0.05）。试验组术后7 d的总有效率显著高于对照组,差异有统计学意义（P<0.05）。试验组与对照组术后7 d的血清白细胞计数和总胆红素都明显低于术前1 d,差异有统计学意义（P<0.05）,且试验组术后7 d与对照组相比也明显降低,差异有统计学意义（P<0.05）。结论经皮经肝胆囊穿刺置管引流术治疗胆结石能促进患者康复,可有效减少并发症的发生,还可抑制血清白细胞计数和总胆红素的释放,提高患者的总体治疗效果。

关键词: 经皮经肝胆囊穿刺置管引流术, 胆结石, 并发症, 总胆红素, 白细胞计数

Abstract: Objective To investigate the effects of percutaneous transhepatic gallbladder puncture and drainage on serum WBC and TBIL in the treatment of gallstones. Methods 204 cases of patients with gallstones diagnosed and treated in Zhengzhou Traditional Chinese Medicine Hospital From January 2020 to May 2022 were selected as the object of the study. Accorded to the 1:1 odd even grouping principle, the patients were divided into the experimental group and the control group with 102 cases in each group. The control group were treated with laparoscopic surgery, and the experimental group were treated with percutaneous puncture and drainage of the liver and gallbladder. Compare the postoperative recovery, incidence of postoperative complications, overall treatment efficacy, and changes in serum white blood cell count and total bilirubin expression between two groups of patients. Results The postoperative anal exhaust time, solid food intake time, postoperative defecation time, and postoperative hospitalization time of the experimental group were significantly shorter than those of the control group, and the diff erence was statistically significant (P<0.05). The incidence of complications such as poor wound healing, abdominal infection, biliary fistula, bile duct injury, and perforation in the experimental group 7 days after surgery was significantly lower than that in the control group, and the difference was statistically significant (P<0.05). The total effective rate of the experimental group at 7 days after surgery was significantly higher than that of the control group, and the difference was statistically significant (P<0.05). The serum white blood cell count and total bilirubin in the experimental group and control group were significantly lower than those on the first day before surgery, and the difference was statistically significant (P<0.05). Moreover, the experimental group also showed a significant decrease on the seventh day after surgery compared to the control group,and the difference was statistically significant (P<0.05). Conclusion Percutaneous transhepatic gallbladder puncture and drainage for the treatment of gallstones can promote patient recovery, effectively reduce the occurrence of complications, inhibit the release of serum WBC and TBIL, and improve the overall treatment effect of patients.

Key words: percutaneous transhepatic cholecystectomy with catheter drainage, gallstone, complication, total bilirubin, white blood cell count

中图分类号:

R657.4

曹欣, 张留龙, 乔虹. 经皮经肝胆囊穿刺置管引流术治疗胆结石对血清WBC和TBIL的影响[J]. 中华养生保健, 2023, 41(12): 50-54.

CAO Xin, ZHANG Liu-long, QIAO Hong. The Effect of Percutaneous Transhepatic Gallbladder Puncture and Drainage on Serum WBC and TBIL in the Treatment of Gallstones[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(12): 50-54.

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