重症急性胆管炎24例治疗体会

目的 探讨重症急性胆管炎(ACST)的外科治疗。方法 回顾性分析24例ACST病人的治疗及预后情况。结果 死亡3例,其中手术治疗死亡1例。早期大剂量应用地塞米松治疗的病人休克得到纠正率(75.0％,6/8),明显高于未用地塞米松的病人(50.0％,2/4)。结论 ACST病人应在出现休克和(或)、精神症状之前手术,对于已出现休克的病人,应先给予适当的保守治疗,病情稳定后再手术;应选择合适的手术方式,加强围手术期的处理,早期大剂量应用地塞米松治疗,以提高教治效果,降低死亡率。

Experience of cure on 24 cases of sever acute cholangitis

Objective To explone the surgery treatment of sever acute cholangitis. Methods Retrospective analysis was made on the treatment and prognosis of 24 patients with ACST. Results 3 cases died, There is I cases died from surgical management. of 8 patients treated with dexamethasone, there are 6 patient whose shocks were corrected. While of 4 patients who were not treated with dexamthasone, only 2 patients shocks were corrected. Conclusion surgical treatment should be done before shock or/and mental confusion was found in patients with ACST; medical treatment should be given first to patients complicated with shock, surgery should be postponed in these cases until the shock is controlled. Select the proper surgical method, enforcing the treantment of perioperation, The early usr of massive dose of dexamethasone, So as to inprove the effects of treatment and reduce the mortal rate.