老年重症急性胆管炎68例治疗体会

目的 探讨老年重症急性胆管炎（ACST）患者的临床特点及手术时机.方法 结合老年人病理生理特点与ACST的关系,对68例患者进行分析.结果 手术52例,治愈48例,死亡4例;非手术治疗16例：12例好转,死亡4例;总病死率11.77%.结论 老年重症急性胆管炎治疗关键,要将老年人病理生理特点与重症急性胆管炎临床特点有机结合起来,在Reynold五联征出现之前及时手术,对出现休克者应适当保守治疗;待病情基本稳定后立即手术.贻误手术时机,严重的并发症及高年龄是老年重症急性胆管炎死亡主要原因.

68 cases therapeutic experience of senile acute cholangitis severe type

Objective] To duscuss the clinical characteristics and the operating opportunities of the senile acute cholangitis severe (ACST) patients. Methods] According to the relationships between senile pathophysiologic characteristics and ACST, 68 patients were selected to the analysis. Results] In operation group with which included 52 cases, 48 cases were cured while 4 cases died. And in non-operation group included 16 cases, 12 cases straightened up while 4 cases died. The total mortality is 11.77%. Conclusion] The key to the therapy of senile ACST is to combile the senile pathophysiologic characteristics to the clinical characteristics of ACST and do operation in time before Reynold's syndrome's appearance. To the patients who have appeared to be shock, conservative treatment shoul be given. When conditions turned to be stable, operation should be done in time. The main causes of death of senile ACST are the delay of operation, severe complications and old age.