老年重症急性胆管炎75例救治体会  

Recognition and treatment on 75 cases with acute severe cholangitis in elderly patients

作　　者：徐金荣[1] 蒋天业[1] 

机构地区：[1]浙江省萧山市第一人民医院普外科,311201

出　　处：《中国全科医学》2001年第2期149-150,共2页Chinese General Practice

摘　　要：目的　探讨老年重症急性胆管炎救治经验。方法　回顾分析 1988年～ 1998年收治的 75例 6 0岁以上重症急性胆管炎患者的病史资料。结果　非手术治疗 9例 ,其中死亡及病情恶化出院 6例 ,好转 3例。手术治疗6 6例 ,均行胆总管切开取石 ,T字管引流 ,其中 30例同时行胆囊切除术 ;手术治愈 6 4例 ,术后死亡 1例 ,病情恶化自动出院 1例 ,全组死亡率 10 6 0 % (手术组为 3 0 3% )。结论　老年重症急性胆管炎患者的临床表现与病变不符 ,易延误诊治 ,病情发展快 ,休克发生率高 ,易发生脏器功能衰竭。本病一旦确诊 ,即应把握时机 。Objective To sum up the diagnosis and treatment of Acute Severe Cholangitis in elderly patients.Methods Retrospective analysis of diagnosis and treatment on 75 cases with ASC was made ,who were hospitalized from 1988 to 1998.Results 9 cases were treated non-operative,6 cases died or discharged from hospital for exacerbation,3 cases were improved.66 cases were treated by operation of choledocholithotomy with T tube drainage,30 cases of them were operated by cholecystectomy at same time;64 cases were cured,one case died,one case was discharged by himself for exacerbation.The death ratio of all was 10.6%,and that of operative group was 3.03%.Conclusion It is likely to delay ASC in elderly because that its clinical manifestation is not corresponded to its condition.So it develops rapidly,and the ratio of shock is high,also it is easy to cause the organ failure.ACST should be operated since its diagnosis is clear.Enhancive treatment during the operative period is the effective method to decrease complication.

关 键 词：老年人 重症急性胆管炎 诊断 治疗 

分 类 号：R657.45[医药卫生—外科学]