老年急性重症胆管炎伴多器官功能不全的手术治疗及时机探讨

目的对手术治疗和综合治疗老年急性重症胆管炎伴多器官功能不全的效果的进行评价。方法回顾我院1994年8月至2008年8月收治的28例老年急性重症胆管炎伴多器官功能不全患者的临床资料。结果28例患者全部接受手术治疗，6例死亡于多器官功能衰竭。24h内手术治疗的病死率明显低于24h后延迟手术治疗的病死率。结论手术时机选择，及时胆道减压，改善重要脏器功能以及合理治疗并存病是防止老年急性重症胆管炎发生多脏器功能衰竭的关键。

Diagnosis and treatment of acute heavy choledochitis combined with multiple organ dysfunction in elders

Objective To evaluate the effectiveness of surgical treatment and comprehensive treatment for elderly patients with heavy choledochitis combined with multiple organ dysfunction. Methods The data of 28 patients with acute heavy choledochitis combined with multiple organ dysfunction admitted in this hospital during past 14 years were retrospectively studied and analyzed. Results All of these patients were undergone operation, 22 patients were cured and 6 cases died. The mortality rate of patients operated within 24h of the disease was significantly lower than that of patients operted after 24h （ P 〈 0.01 ） . Conclusiom Timing of surgery, biliary decompression in time to improve the function of vital organs, and reasonable treatment of both diseases is to prevent severe acute cbolangitis in elderly multiple organ failure oeccrred in the key.