老年人重症急性胆管炎的诊断与治疗

目的：探讨老年人重症急性胆管炎(ACST)的诊断与治疗。方法：对我院1998--2002年收治的老年人ACST患者43例进行回顾性分析。结果：43例均进行手术治疗。其中有并存病27例，占62．79％。发生术后并发症14例，占32．58％。死亡10例，占23．26％。结论：老年ACST发病急聚、进展迅猛、并存病多、术后并发症多、病死率高。治疗中应强调早期诊断、及时施行胆道减压、通畅引流，有效防治胆源性休克，避免MOSF发生，积极治疗并存病、并发症，提高治疗效果，降低死亡率。

THE DIAGNOSIS AND TREATMENT OF ACST IN THE OLD PATIENTS

Objective: To investigate the diagnoses and therapy of ACST.Methods:We retrospectively analyzed 43 cases of elderly patients with ACST in our hospital from 1998 to 2002. Results:All 43 cases performed operation in which 27 cases coexisted with other disease and 14 cases had complications and 10 cases died. The proportions were 62.79 %, 32.58% and 23.26 % respectively. Conclusions: Onset and progression of ACST are rapid and ACST coexist with other disease commonly. Also ACST has many postoperative complications and the fatality rate is high. We must emphasize diagnosis in early period, biliary tract decompression and unobstructed drainage in time,prevention and cure of shock origin ating in bite effectively, refrain from MSOF, therapy of coexisted disease and complications actively in order to improve the result and decrease fatality rate.