论文部分内容阅读
目的探讨急性结石性胆囊炎并发肝功能损害患者采用手术治疗的临床疗效。方法 70例急性结石性胆囊炎合并肝功能损害患者,根据炎性程度分为轻度组(27例)、中度组(19例)以及重度组(24例),观察手术治疗效果,比较三组肝功能变化。结果患者全部手术进展顺利,平均手术用时(73.47±18.36)h。经过消炎、抗感染治疗及手术治疗后,无死亡病例,未出现胆管受损、出血等术后并发症。手术后复查肝功能,70例肝功能损害的患者中,有37例患者治愈,29例患者好转,另外4例患者未好转,手术治疗并发肝功能损害的急性结石性胆囊炎患者的总有效率为94.29%。重度组及中度组患者的谷丙转氨酶(ALT)、谷草转氨酶(AST)及总胆红素(TBIL)均高于轻度组,血清白蛋白(ALB)低于轻度组,差异具有统计学意义(P<0.05);重度组患者的ALT、AST及TBIL高于中度组,ALB低于中度组,差异具有统计学意义(P<0.05)。结论手术治疗并发肝功能损害的急性结石性胆囊炎临床疗效确切,抗感染、保肝护肝联合手术治疗可有效促进肝功能的恢复,且ALT、AST、TBIL、ALB可作为了解并发肝功能损害的急性结石性胆囊炎病情的指标。
Objective To investigate the clinical efficacy of surgical treatment of patients with acute calculous cholecystitis complicated with liver dysfunction. Methods Seventy patients with acute calcific cholecystitis and liver dysfunction were divided into mild group (n = 27), moderate group (n = 19) and severe group (n = 24) according to the degree of inflammation. Group liver function changes. Results All the patients progressed smoothly with the average operative time (73.47 ± 18.36) h. After anti-inflammatory, anti-infective treatment and surgical treatment, no deaths, no bile duct injury, bleeding and other complications. Of the 70 patients with liver dysfunction who underwent surgery, 37 were cured, 29 were improved, 4 were not improved, and the total effective rate of surgery for patients with acute calcific cholecystitis with hepatic impairment 94.29%. The levels of ALT, AST and total bilirubin (TBIL) in severe group and moderate group were significantly higher than those in mild group, while those in serum albumin (ALB) were lower than those in mild group (P <0.05). ALT, AST and TBIL in severe group were significantly higher than those in moderate group and ALB was lower than those in moderate group (P <0.05). Conclusions Surgical treatment of acute calcific cholecystitis complicated by hepatic dysfunction has definite clinical curative effect. Combining with anti-infective, hepatoprotective and hepatotoxicity combined with surgical treatment can effectively promote the recovery of hepatic function. And ALT, AST, TBIL and ALB can be used as a guide to understand the complications of hepatic dysfunction Acute calcific cholecystitis condition indicators.