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作 者:刘思义[1] 黄鹏[1] 朱革非[1] 李明武[1]
出 处:《中国医师进修杂志》2014年第20期38-40,共3页Chinese Journal of Postgraduates of Medicine
摘 要:目的总结探讨急性梗阻性化脓性胆管炎(AOSC)死亡的相关因素。方法回顾性分析56例AOSC患者的临床资料。结果死亡6例,其中5例酸中毒,5例血小板减少,5例体温明显变化,4例合并心、肺、肾基础疾病或糖尿病,5例手术及麻醉时间≥150min,5例发病距就诊时间≥72h,18例年龄≥70岁的老年患者死亡4例。年龄≥70岁,体温≥39℃或〈36℃,合并酸中毒,血小板计数≤6.0×10^12/L,合并心、肺、肾等基础疾病或糖尿病,麻醉及手术时间≥150min,发病距就诊时间≥72h患者病死率较高,差异有统计学意义(P〈0.05)。结论年龄、体温明显异常、血小板明显减少、合并心、肺、肾等基础疾病或糖尿病、酸中毒、麻醉及手术时间过长、发病距就诊时间≥72h等是AOSC的死亡因素。Objective To summarize and investigate the lethal factor of acute obstructive suppurative cholangitis(AOSC). Methods The clinical data of 56 patients with AOSC were retrospectively analyzed. Results Six cases died, 5 cases with acidosis, 5 cases with thrombocytopenia and 5 cases with temperature change obviously, 4 cases with heart, lung and kidney disease or diabetes, 5 cases with operation and operation time I〉 150 rain,5 cases with from onset to treatment time ≥72 h. Eighteen cases of elderly patients ≥70 years old,4 cases died. The patients whose age≥70 years, temperature ≥39 ℃ or 〈 36 ~C, combined with acidosis, platelet counts≤6.0×10^12/L, with heart,lung, kidney diease or diabetes, time of anesthesia and operation ≥ 150 min and from onset to treatment time 1〉72 h had higher death rate (P 〈 0.05). Conclusion Age,obvious temperature abnormalities, significantly platelet decrease, with heart, lung, kidney diease or diabetes, acidosis, long time of anesthesia and operation and from onset to treatment time ≥ 72 h are the lethal factor of AOSC.
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