| Objective: To explore the efficacy of ultrasound-guided puncture and drainage in the treatment of liquefied hollow hepatic alveolar hydatid disease,and the timing of radical surgery after puncture and drainage.Methods: Collected the case data of 52 cases of hepatobiliary and pancreatic surgery in the Affiliated Hospital of Qinghai University who were admitted to the study from October 2014 to March 2020 and included in the study.General information,laboratory examination,quality of life score,puncture time and 24-hour drainage volume were collected for statistical analysis,After puncture and drainage,22 of the 52 patients received radical surgical treatment.According to the median puncture and drainage time of 25 days,they were divided into two groups: group A(drainage time ≦25 days)and group B(drainage time > 25 days),with 11 patients in each group,The general information,laboratory examination,postoperative complications,average length of stay and tube days of the two groups were collected for statistical analysis.Results:1.After puncture and drainage,the laboratory indicators(GGT,ALP,TBIL,DBIL,IBIL,ALB,PT,APTT,HGB)of patients before puncture,1 day,3 days and 1 week after puncture were analyzed by Friedman’s non-parametric test,and the differenceswere statistically significant(P <0.05).After pair comparison,compared with P<0.05,there were statistically significant differences in ALP and GGT before puncture and 1 day,3 days and 1 week after puncture(P<0.05),and there were statistically significant differences in ALP and GGT 1 day and 1 week after puncture(P<0.05).There were statistically significant differences in TBIL indexes before and 3days and 1 week after puncture,and 1 day and 3 days and 1 week after puncture(P < 0.05).There were statistically significant differences in DBIL indexes before puncture and 1 week after puncture,1 day after puncture and1 week after puncture(P < 0.05).There were statistically significant differences in ALB indexes before puncture,1 day and 3 days after puncture,and 1 day and 1 week after puncture(P < 0.05).APTT was compared before puncture and 3 days and 1 week after puncture,and the difference was statistically significant(P < 0.05).There were statistically significant differences in HGB before and 1 day after puncture,1 day and 1 week after puncture,3 days and 1 week after puncture(P < 0.05).2.The patient’s quality of life gradually improved from before puncture and drainage to 3 days,1 week,2 weeks,and 1 month after puncture and drainage,The quality of life score of the patients gradually reached the average and better state from the poor score before puncture and drainage to the time after puncture and drainage.3.The lesions after puncture were significantly smaller than those before puncture,and the difference was statistically significant(P<0.05).4.Patients receiving radical surgery after puncture: there was statistically significant difference in APTT 1 day after operation between group A(puncture catheter drainage time ≦25 days)and group B(puncture catheter drainage time > 25 days)(P<0.05).PT and APTT were significantly different at 3 days after operation(P<0.05).There was a significant difference between the two groups of patients in terms of the number of days after operation and the number of days in hospital(P<0.05).Conclusion:For patients with liquefied cavitary liver alveolus echinococcosis,puncture and drainage treatment is safe and reliable.It can effectively reduce the focus of the disease,relieve the pain in the liver area of the patient,improve the liver function,improve the blood coagulation function,and improve the quality of life of the patient,so as to buy time and opportunities for follow-up treatment.Radical surgery is performed as soon as possible after puncture and drainage,the patient’s blood coagulation function recovers quickly,and the postoperative hospital stay and postoperative catheter time are significantly shortened. |
