老年重症急性胆管炎46例临床分析

Clinical analysis of 46 aged patients with acute cholangitis of severe type

摘要: 目的: 探讨老年重症急性胆管炎(acute cholangitis of severe type,ACST)的临床特点及治疗方法。方法: 对1994~2003年收治的46例老年ACST患者进行回顾性分析。结果: 全组死亡12例,病死率26.1%,其中死于中毒性休克7例(58.3%),器官功能衰竭5例(41.7%)。结论: 老年ACST具有临床表现不典型、并存病多,易发生休克、电解质紊乱和器官功能衰竭等特点。外科治疗应做好必要的术前准备,选择适当的手术时机和手术方式,加强术后管理等。其中手术时机的选择是老年ACST治疗成败的关键。

Abstract: Objective: To explore the clinical features and methods for treatment of acute cholangitis of severe type(ACST) in the aged.Methods: Forty-six aged patients with ACST treated in our hospital from 1994 to 2003 were analyzed retrospectively.Results: Twelve patients died,with a mortality of 26.1%,7 of whom died of toxic shock(58.3%) and 5 died of multiple organ failure(41.7%).Conclusions: The ACST in the aged patients has the characteristics of lack of typical clinical manifestations,more coexisting diseases, toxic shock,electrolyte disturbance and multiple organ failure.Good pre-operative preparations,choice of operation time and procedure,good postoperative management are the key to the success of the operation.