45例急性重症型胆管炎的外科治疗

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 分析45例ACST病人的治疗及预后情况。结果 本组死亡7倒，其中手术治疗组死亡4例，早期大剂量地塞米松治疗的病人休克纠正率明显高于未用地塞米松组。654—2与地塞米松联用较单用地塞米松更有效。结论 ACST病人应在出现五联征之前手术，对于已出现休克的病人，应先给予适当的保守治疗，待病情稳定后再手术。高龄、贻误手术时机和出现严重并发症是死亡的主要原因；早期大剂量应用地塞米松，并加用654—2治疗ACST，临床效果更佳。

Analysis of the Surgical Treatment on Acute Cholangitis of Severe Type

Objective To investigate the opportunities of surgical treatment and causes of death a-bout acute cholangitis of severe type (ACST). Methods To analyze the treatment and prognosis about 45 patients suffering from ACST. Results In 45 cases, 7 patients were dead, including 4 patients received surgical treatment. The cure rate of shock of these patients who had early received high doses dex-amethasone treatment were better than those ones who had not been given dexamethasone. This effect of combined treatment of 654-2 and dexamethasone was better than one of dexamethasone simply. Conclusions Before patients of ACTS express pentalogy, surgical treatment should be given to them. However, an appropriate conservative treatment should be provided to those patients who have shown symptoms of shock, and after these patients' condition is in a calm, surgical treatment should be supplied. These causes, such as: advanced age, delaying the chances of surgical treatment, serious complication and so on, are primary factors. As to the treatment of ACST, it's necessary that dexamethasone should early be given, and the better effect that dexamethasone and 654 - 2 are used at the same time will be shown.