急性非结石性胆囊炎的诊治分析  

Clinical Analysis of Acute Acalculous Cholecystitis

作　　者：戴途[1] 李建平[1] 陈波[1] 季沅[1] 

机构地区：[1]江苏省无锡市第二人民医院,江苏无锡214002

出　　处：《中国临床医学》2008年第1期80-81,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨急性非结石性胆囊炎的临床诊断和治疗的方法。方法:对28例急性非结石性胆囊炎的术前资料、手术时机、治疗方法和并发症进行回顾分析。在发病48h内手术方式以胆囊切除为主,发病48h后手术方式以胆囊大部切除术和加胆囊造口术为主。结果:28例患者中,大于60岁者20例(71.4%),其中有合并症22例次(78.6%),发生于大手术和严重创伤后共21例(75.0%)。在发病48h内手术者,胆囊病变以化脓多见,而发病48h后手术者,胆囊病变主要为坏疽与穿孔;在发病48h内手术方式以胆囊切除为主,发病48h后手术方式以胆囊大部切除术和胆囊造口术为主;发病48h内手术的并发症与死亡率均较48h后手术者低。结论:急性非结石性胆囊炎常见于老年人,合并症多,常发生于大手术和严重创伤后,宜在发病48h内尽早手术。Objective：To investigate the clincal diagnosis and treatment of acute acalculous cholecystitis（ACC）. Methods：The preoperative data, appropriate time of operation, methods of treatment and complication of 28 ACC patients were analyzed retrospectively. Results： The exceeded 60 years cases of ACC were 20（71.4%） and with complications were 22 （78.6%）, the patients who had ACC after major operation or severe trauma were 21 （75.0%）. The major cholecyst pathological changes of pa- tients who had ACC within 48h was purulent inflammation, the major cholecyst pathological changes of patients who had ACC after 48 h were gangrene or/and perforation. The major operation method of patients who had ACC within 48h was cholecystectomy, the major operation method of patients who had ACC after 48 h were large partial excision gall bladder or cholecystos- tomy. The complication and fatality of patients who had ACC within 48 h was less than patients who had ACC after 48h. Conclusion：ACC is happened frequently in old people and after major operation or severe trauma , also with mang complications, Operation should be performed within 48h.

关 键 词：急性非结石性胆囊炎 胆囊切除术 并发症 

分 类 号：R575.61[医药卫生—消化系统]