手术治疗老年人重症急性胆管炎60例分析

目的 分析老年人急性重症胆管炎的特点、手术时机及围术期处理.方法 回顾性分析60例老年人急性重症胆管炎的临床资料.结果 60例老年人急性胆管炎均手术治疗,治愈44例(73.3%),死亡16例(26.7%),发病24 h内手术者死亡3例(18.8%),明显低于发病24 h后手术者死亡13例(81.3%,X2=7.72,P<0.01);术前休克已纠正手术者40例,死亡6例(15.O%),术前休克未纠正手术者20例,死亡10例(50.0%),两者比较,差异有统计学意义(X2=6.75,P<0.01).结论 及早诊断、及时手术、做好围手术期处理是提高老年人急性重症胆管炎治愈率的关键.

Surgical treatment of severe acute cholangitis in aged patients

Objective To analyze the characteristics and therapeutic effects in the elderly patients with acute eholangitis of severe type(ACST) Methods The clinical data of 60 cases of elderly patients with ACST. Results The cured 44 cases(73.3% )and 16 deaths(26.7% ) ,the cause of death:septic shock four cases (25.0%) ,3 cases of acute renal failure(18.8%) ,ARDS four cases(25.0% ) ,multi - organ failure five cases(31.3% ). Incidence surgery within 24 h the deaths of three cases( 18.8% ) ,significantly less than 24 h after surgery incidence death in 13 cases (81.3%) ( X2= 7.72, P<0.01 );correct preoperative shock has been 40 cases, six cases of death ( 15.0% ) was significantly lower than the preoperative shock not corrected in 20 cases,death in 10 patients(50.0% ) ( X2=6.75 ,P <0.01 ). Conclusion The cure rate was improved from early diagnosis and perioperative management in the elderly patients with acute cholangitis of severe type.