| Objective:by observing the general relieving decoction treatment of elderly patients with acute cholecystitis Percutaneous via hepatic Gallbladder puncture Drainage(Percutaneous Transhepatic Gallbladder Drainage,PTGD)after improvement of symptoms and signs,postoperative recovery,the incidence of postoperative complications and some laboratory indexes down to explore its action mechanism,evaluation on relieving decoction in the treatment of elderly acute cholecystitis PTGD postoperative clinical value.Methods:a retrospective analysis in March,2017-December 2019 in Beijing university of Chinese medicine dongzhimen hospital general surgery were all diagnosed with elderly patients with acute cholecystitis parallel PTGD,selected to meet the requirements of this experiment included in standard 49 cases aged over 65 elderly patients with acute cholecystitis as the research object,according to all the 49 cases in PTGD whether oral or nasal feeding Chinese medicine on relieving postoperative soup,49 patients were randomly divided into treatment group(n=26)and control group(n=23).All the 23 patients in the control group underwent ultrasound-guided percutaneous transhepatic puncture and drainage of liver and gallbladder in the ward or operating room for treatment needs within 24 hours after admission,and were routinely treated with fasting water,anti-inflammatory,acid-inhibiting,fluid supplementation and other western medicine comprehensive conservative treatment.On the basis of the treatment in the control group,the 26 patients in the observation group were additionally treated with tongfu decoction or nasal feeding after PTGD,one dose per day and two doses in the morning and evening according to the actual conditions of different patients.Seven days after the operation of PTGD was set as a course of treatment,and the changes of TCM syndrome score and clinical efficacy of the two groups were observed before and after 7 days of treatment.The time taken by the two groups when the body temperature returned to normal after treatment was compared.The white blood cell count of the two groups decreased 3 days and 7 days after treatment.The incidence of bile leakage,pulmonary infection and other postoperative complications in the 7 days after PTGD in the two groups were calculated and compared.Results:1.Before treatment,the basic data of the two groups of patients were analyzed:the age of the treatment group was 65-85 years old,including 11 males and 15 females,with an average age of(73.00±6.073)years old.The age of the control group was 65-84 years,including 9 males and 14 females,with an average age of(72.09±5.656)years.All patients received PTGD successfully once,and the operative time and intraoperative blood loss were within the normal range.Baseline data showed no significant statistical difference between the two groups(P>0.05),which could be compared.2.The scores of TCM symptoms of the two groups were compared after 7 days of treatment,and the treatment group was superior to the control group,with statistically significant difference(P<0.05).3.Comparing the clinical efficacy of the two groups after 7 days of treatment,the total clinical efficiency of the treatment group(53.85%)was better than that of the control group(43.48%),but there was no statistical difference in the total effective rate of the two groups after treatment(P>0.05).4.The comparison between the two groups showed that the treatment group was significantly better than the control group when the body temperature returned to normal(P<0.05).5.Compared with the control group,the first anal exhaust time of patients in the treatment group was shorter than that in the control group,and the difference was statistically significant(P<0.05).6.After 3 days of treatment,the reduction of white blood cell count in the treatment group was better than that in the control group,and the difference was statistically significant(P<0.05).After 7 days of treatment,the white blood cell count of the two groups decreased to the normal range,with no statistically significant difference(P>0.05).7.Compared with the postoperative complications in the two groups within 7 days after surgery,the incidence of complications in the treatment group(11.54%)was lower than that in the control group(21.74%),but the chi-square test showed no statistically significant difference(P>0.05).Conclusion:tongfu decoction after PTGD is effective in the treatment of senile acute cholecystitis,which can significantly improve the clinical symptoms of patients,improve the systemic and local inflammatory response of patients,and shorten the course of disease,so it is worthy of clinical application. |
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