ABSTRACT
Abstract Objectives This study aimed to investigate the efficacy of ultrasound-guided Percutaneous Transhepatic Biliary Drainage (PTCD) for the treatment of Acute Obstructive Suppurative Cholangitis (AOSC) combined with septic shock due to choledocholithiasis, and its effect on inflammatory factors. Methods Clinical data of 86 patients with AOSC and septic shock admitted to our hospital between January 2019 and May 2021 were retrospectively analyzed and grouped according to different treatment methods. Among them, 43 patients who underwent Endoscopic Retrograde Cholangiopancreatography (ERCP) and Endoscopic Nasobiliary Drainage (ENBD) were included in the Control Group (CNG), and 43 patients who underwent ultrasound-guided PTCD were included in the Study Group (SG). Results The total effective rate in the SG (88.37%) was higher than that in the CNG (69.77%) (p <0.05); after surgery, the serum inflammatory factors PCT, IL-6, TNF-α, CRP levels, liver function indicators such as TBIL, DBIL, AST, ALT levels, and stress response indicators including NPY, PGE2, 5-HT levels were reduced, and were lower in the SG than in the CNG (p <0.05); postoperatively, CD3+, CD4+, and CD4+/CD8+ levels in the CNG were significantly lower than those before surgery (p <0.05); Postoperatively, CD3+, CD4+, and CD4+/CD8+ levels in the SG were significantly higher than those in the CNG (p <0.05); and the complication rate in the SG (6.98%) was lower than that in the CNG (25.58%) (p <0.05). Conclusions Ultrasound-guided PTCD for AOSC combined with septic shock can facilitate the recovery of liver and immune functions with a low complication rate.
ABSTRACT
Objective To investigate the expression of scavenger receptor A(SR-A) in rat liver tissues during acute obstructive suppurative cholangitis(AOSC) and its relations with inflammatory mediators and hepatic injury.Methods Wistar rat models of AOSC were reproduced by ligating choledochus and inside injecting Escherichia coli O111∶B4.The plasma endotoxin concentrations,TNF-? levels and expressions of SR-A protein and mRNA in liver tissues were assayed by limulus test,ELISA,immunohistochemistry and RT-PCR,respectively.Pathological changes of liver tissues were observed under light microscope.Results With the time prolonged,the plasma endotoxin concentrations and the TNF-? levels gradually increased,but the SR-A protein and mRNA expressions decreased in the rats of experimental group,significantly different with those in sham operation group and normal saline group(P