急性非结石性胆囊炎的诊断治疗分析

目的总结急性非结石性胆囊炎的诊断和治疗经验。方法对我院1999年3月—2010年11月收治的19例急性非结石性胆囊炎患者的临床资料进行回顾性分析。结果 19例患者均行手术治疗,其中胆囊切除12例,胆囊大部切除2例,胆囊造瘘3例,胆总管探查、T管引流2例。术前误诊7例,误诊率36.8%。除2例死于术后多脏器功能衰竭外,其余病例均治愈出院。结论急性非结石性胆囊炎病情急、进展快、临床表现不典型。早期诊断和及时手术治疗是提高其治愈率和降低死亡率的关键。

Analysis on diagnosis and treatment of acute acalculous cholecystitis

Objective To summarize the experience of diagnosis and treatment of acute acalculous cholecystitis（AAC）. Methods 19 cases with AAC in our hospital from March 1999 to November 2010 were retrospectively analyzed. Results 19 patients,all of them received operation on gallbladder.12 cases were treated with cholecystectomy,2 cases received partial cholecystectomy,3 cases received cholecystostomy,2 cases with exploration of the common bile duct and T tube drainage.Before surgery,7 cases were misdiagnosed,the misdiagnosis rate was 36.8%.The clinical outcomes were that 2 cases died from multiple organ dysfunction symdrome（MODS） and the others were curative. Conclusion AAC is an acute progress disease with non-obviousness symptoms and signs.Early diagnosis and timely treatment for AAC patients are crucial in increasing cure rate and decreasing mortality rate.