损伤控制在老年急性梗阻性化脓性胆管炎中的应用  

Damage Control Surgery(DCS) for Acute Obstructive Suppurative Cholangitis(AOSC) in Elderly People

作　　者：院存珍[1] 丁伟健 樊晨[1] 

机构地区：[1]中国人民解放军第264医院普外科,太原030001

出　　处：《中国医药导刊》2014年第4期605-606,共2页Chinese Journal of Medicinal Guide

摘　　要：目的：探讨损伤控制在老年急性梗阻性化脓性胆管炎中的应用。方法：回顾分析我院2006年1月-2012年1月70岁以上由结石引起的急性梗阻性化脓性胆管炎患者60例,根据不同的处理方式分为内镜及介入治疗组（简称非手术组）（n=30）,手术治疗组（n=30）.分析两组治疗方法的效果,并发症发生率、死亡率。结果：非手术治疗组与手术治疗组并发症发生率是（6.7%vs40%）,P〈0.05,死亡率是3.3%vs10%）,P〈0.05。结论：对老年急性胆管炎患者,在损伤控制理论指导下,应用内镜及介入治疗创伤小、安全有效,是其首选的治疗方式。Objective： To explore the effect of damage control surgery （DCS） for acute obstructive suppurative cholangitis （AOSC）. Methods：60 case AOSC elderly patients over 70 from Jan 2006 to Jan 2012 in our department were enrolled and assigned to non-operation group （n=30）, operatiove treatment group （n=30） based on different way of management. Two groups data regarding complication incidence and mortality rate were analyzed and compared. Results：The mortality rates were 3.3%and 10%（P〈0.05） in non-operation group and operative trentment group,respectively. complication rate 6.7%and 40%（P〈0.05）in non-operative group and operative trentment group. Conclusion：Under DCS leadeing, endosocpic nasobiliary drainage（ENBD）, endosopic sphicterectomy （EST）＋endosocpic nasobiliary drainage（ENBD）and percutaneous transhepatics cholangiography drainage（PTCD）were effective and safe for AOSC patients aged over 70,They are treatment of first choice.

关 键 词：老年 急性梗阻性化脓性胆管炎 损伤控制(DSC) 鼻胆管引流 

分 类 号：R657.4[医药卫生—外科学]