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(ACST)病人的手术时机及死亡原因。方法 回顾性分析116例ACST病人的治疗及予后情况。结果 围手术期死亡10例。在中毒性休克6h内行手术者全部存活，超过24h8例，除1例幸存外，余7例均于术后1～4d死于中毒性休克、多器官功能衰竭。结论 ACST病人应在出现休克或精神症状之前采用手术治疗，越早手术效果越好；延误手术时机、严重并发症、高龄是死亡的主要原因。

Discussion of the Operative Timing and Cause of Death in the Patients with Acute Cholangitis of Severe Type

Objective To explore the operative timing and cause of death in the patients with acute cholangitis of severe type(ACST). Methods The clinical data on the treatment and the prognosis of 116 patients with ACST were analyzed retrospectively. Results 10 cases died during perioperative period.The patients who received operation within 6 hours after toxic shock all survived.Of 8 cases who received operation after 24 hours,7cases died from toxic shock and multiple organ deficiency of function (MODF) within 4 days of post-operation. Conclusion Operation should be performed before toxic shock or mental symptom occurred in the patients with ACST. The earlier the operation was performed, and the better the prognosis was. The main causes of death were delayed operative time,severe complications and senility.