急性无结石性胆囊炎31例的危险因素、诊治及预后分析

目的:探讨急性无结石性胆囊炎的诊断、外科治疗方法、危险因素及预后。方法:对2002年1月~2007年2月31例急性无结石性胆囊炎的临床资料进行回顾性分析。结果:急性无结石性胆囊炎多见于年老体弱患者,病因复杂,病情进展迅速,死亡率高,一经确诊,应及时手术治疗。本组31例患者中,25例行胆囊切除术,2例行胆囊大部分切除术,2例行胆囊造口术,1例胆囊内置PTCD管引流,1例行胆囊切除、胆总管切开探查、T管引流术;1例胆囊切除术后死亡,死因为感染性休克,多器官功能衰竭。结论:B超和实验室检查是诊断本病的主要依据,早期诊断并采取积极的手术治疗是提高本病治愈率的关键。

Analysis of diagnosis, treatment, risk factors and prognosis of acute acalculous cholecystitis

Objective:To investigate the diagnosis,treatment,risk factors and prognosis of acute acalculous cholecystitis(AAC).Methods:The clinical data from AAC patients treated in our hospital from January 2002 to February 2007 were analyzed retrospectively.Results:AAC often occurred in elderly people and its clinical features included complicated pathogenesis,rapid progress and high mortality.It should be surgically treated once the final diagnosis was established.Of the 31 patients, 25 underwent cholecystectomy,2 partial cholecystectomy,2 cholecytostomy,1 exploration of common bile duct,and 1 PTCD.There was 1 case of post operative death due to septic shock and multiple organs failure.Conclusion:B-mode ultrasonography and laboratory examination are the main methods for diagnosis of AAC.Early diagnosis and positive operation are important to raise the curative rate of AAC.