急性梗阻性化脓性胆管炎合并糖尿病引发严重腹腔感染的治疗  

Treatment for severe abdominal infection caused by acute obstructive suppurative cholangitis combined with diabetes mellitus

作　　者：冉启华[1] 李莉洁[1] 廖小强[1] 陈颖虎[1] 

机构地区：[1]解放军第四二五医院普通外科,三亚572008

出　　处：《中华消化外科杂志》2014年第7期582-583,共2页Chinese Journal of Digestive Surgery

摘　　要：急性梗阻性化脓性胆管炎（AOSC）是临床中凶险的急腹症之一,又称为急性重症胆管炎.若该病合并糖尿病,其发生腹腔感染的危险性大大增加,并进一步引发胆汁漏、肠瘘等,导致生命危险.而腹腔感染的处置得当与否对患者预后非常关键.2013年5-7月解放军第四二五医院收治1例AOSC合并糖尿病患者,因家属早期拒绝手术、手术前后血糖控制不严格致反复腹腔感染、脓肿形成,引发胆汁漏、肠瘘等严重并发症.患者经3次手术、禁食、胃肠减压、肠外营养及应用生长抑素、加强抗感染等治疗后痊愈出院.Acute obstructive suppurative cholangitis （AOSC） is one of the most serious acute abdomen.The incidence of abdominal infection is significantly improved when patients were complicated with AOSC and diabetes mellitus,and then bile leakage,intestinal fistula and even death were induced by abdominal infection.The management of abdominal infection is very important for the prognosis of patients.One patient with AOSC and diabetes mellitus was admitted to the No.425 Hospital of PLA from May to July in 2013.Recurrent abdominal infection and abscess occurred after the operation due to his family members＇ refusal of surgery at early period and lax control of blood glucose before and after surgery,and then bile leakage and intestinal fistula were induced.The patient underwent operation for 3 times,and was cured after receiving fasting,gastrointestinal decompression,parental nutrition,somatostatin administration and antibiotic treatment.

关 键 词：急性梗阻性化脓性胆管炎 糖尿病 腹腔感染 

分 类 号：R587.1[医药卫生—内分泌] R657.45[医药卫生—内科学]