重症、急性胆管炎的诊治体会

本文报导1974年1月至1984年12月,我科共收治重症、急性胆管炎394例,其中299例作了手术处理。死亡77例,病死率为19.54％。在本症诊断时,强调肝内型急性胆管炎和肝外型的临床表现不同,但二者往往可同时存在,呈混合型,并且可转化,难以区分。在处理时,应密切观察,认真对待,选择恰当的手术时机,及时、有效地做胆道减压引流,并建议加强寄生虫病的防治工作和术后定期随诊工作。

A preliminary experience on diagnosis and treatment of acute cholangitis of severe type

394 cases of acute cholangitis of severe type were presented, from January 1974 to December 1984. Among these, 299 cases were performed. 77 cases died. The mortality rate was 19. 54%. During diagnosis of this disease, the difference of thief clinical features between the intrahepatic and extrahepatic type was emphasized. However both types often coexist and presnt a mixed type. They can be not only changeable each other, but also difficult in distinguishing between the two types. During the management, careful observatlon and correct treatment must be adopted. Choise of the timing of operation for the illnoss should be appropriated. Prompt effective decompression of the common bile duct wito T-tube drainage should be done. The authors suggest that we must enhance the preventive and treated works on parasitic disease and that postoperative follow-up should be carried out regularly.