【摘要】 目的：观察经皮经肝胆囊穿刺引流术（PTGBD）联合延期腹腔镜胆囊切除术（LC）治疗急性结石性胆囊炎患者的效果。方法：选取80例急性结石性胆囊炎患者为研究对象，按照随机数字表法分为对照组和观察组各40例。对照组予以LC治疗，观察组予以PTGBD联合延期LC治疗，比较两组围术期指标[体温恢复时间、腹痛缓解时间、白细胞恢复时间与抗生素使用时间]水平、手术前后炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素（IL）-6和IL-8]水平、T细胞亚群指标[CD3+、CD4+]水平和术后1个月并发症发生率。结果：观察组体温恢复时间、腹痛缓解时间、白细胞恢复时间和抗生素使用时间均短于对照组，差异有统计学意义（P<0.05）；术后3 d，观察组TNF-α、IL-6、IL-8水平均低于对照组，差异有统计学意义（P<0.05）；两组CD3+、CD4+水平均低于术前，但观察组高于对照组，差异有统计学意义（P<0.05）；观察组术后并发症发生率为2.50%(1/40)，低于对照组的20.00%(8/40)，差异有统计学意义（P<0.05）。结论：PTGBD联合延期LC治疗急性结石性胆囊炎患者可降低围术期指标水平、炎性因子水平和术后并发症发生率，提高T细胞亚群指标水平，效果优于单纯LC治疗。更多还原

【Abstract】 Objective: To observe effects of percutaneous transhepatic gallbladder drainage(PTGBD) combined with delayed laparoscopic cholecystectomy(LC) in treatment of patients with acute calculous cholecystitis. Methods: 80 acute calculous cholecystitis patients were selected as the research objects, and were divided into control group and observation group according to the random number table method, 40 cases in each group. The control group was given LC treatment, while the observation group used PTGBD combined with delayed LC treatment. The levels of perioperative indicators [body temperature recovery time, abdominal pain relief time, leukocyte recovery time and antibiotic use time], the inflammatory factor levels [tumor necrosis factor-α(TNF-α), interleukin(IL)-6 and IL-8], the T cell subset indicator levels(CD3+, CD4+) and 1 month postoperative complication rate were compared between the two groups. Results: The body temperature recovery time, the abdominal pain relief time, the leukocyte recovery time and the antibiotic use time in the observation group were shorter than those in the control group, and the differences were statistically significant(P<0.05). 3 days after the surgery, the levels of TNF-α, IL-6 and IL-8 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05). The levels of CD3+ and CD4+ in the two groups were lower than those before operation;those of the observation group were higher than those of the control group; and the differences were statistically significant(P<0.05). Further, the incidence of postoperative complications in the observation group was 2.50%(1/40), which was lower than 20.00%(8/40) in the control group, and the difference was statistically significant(P<0.05). Conclusions: PTGBD combined with delayed LC in the treatment of the patients with acute cholecystitis can reduce the levels of perioperative indicators, the inflammatory factors and the postoperative complications, and increase the levels of T cell subset indicators. Moreover, it is superior to single LC treatment.更多还原