急性重症胆管炎21例治疗分析

目的 :探讨急性重症胆管炎病人的手术时机和死亡原因。方法 :回顾性分析 2 1例急性重症胆管炎病人的治疗及预后情况。结果 :死亡 2例 (手术死亡及传统治疗死亡各 1例 )。早期大剂量短期应用糖皮质激素病人休克得到纠正率 85 % ,明显高于未用糖皮质激素病人休克纠正率 5 0 %。结

Management of Severe Acute Cholangitis of 21 Patients

Objective: To investigate the opportunity of operation and the reason of death in patients with ACST. Methods: Retrospective analysis was made on the treatment and prognosis of 21 patients with ACST. Results: 2 (10%) of 21 patients died from surgical treatment. Of 14 patients treated with glucocortcoid (GC), there were 12 patients whose shock was improved. In contrast, of 4 patients not treated with GL, there were only 2 patients whose shock was improved. Conclusion: Surgical treatment should be done before shock or/and mental confusion occurred in the patients with ACST. Otherwise surgical treatment should be postponed until shock is controlled. Missing the opportunity of operation, having severe complication (e.g. MOSF), and being old age are the major reasons of death.