急性重症胆管炎手术时机和死亡原因的探讨

目的　探讨急性重症胆管炎的手术时机与死亡原因。方法　回顾性分析 1992年 6月～ 2 0 0 0年 12月收治的急性重症胆管炎 136例。结果　术后临床痊愈 113例。围手术期死亡 2 3例 ,术后 72h内死亡 16例 ,72h以后死亡4例 ,总死亡率 16 9% (2 3/136 )。死亡原因为多系统器官衰竭 9例 ,DIC 4例 ,感染性休克 4例 ,糖尿病酮症酸中毒 3例 ,ARDS 3例。结论　急性重症胆管炎的早期判断、手术前的充分扩容治疗及手术时机与手术方式的掌握 ,是减少并发症和降低死亡率的关键

ANALYSIS OF DEATH CAUSES AND SELECTION OF OPERATIONAL TIMING FOR PATIENTS WITH ACUTE SEVERE CHOLANGITIS

Objective To evaluate timing of operation cause of death of acute cholangitis of severe type (ACST).Method From June 1992 to December 2000,136 cases with acute cholangitis of severe type were included.Results 113 patients were cured.The mortality was 16.9%.The major death cause were multiple organ dysfunction syndrome(9 cases),DIC(4 cases),infective shock(4 cases),diabetes ketosis toxicosis (3 cases),ARDS(3 cases).Conclusion Early diagnosed,and well management before operation and selecting the operative timing are the key to reducing complications and mortality rate.