胆道感染性休克的治疗(附405例分析)

目的评价各种治疗手段对胆道感染性休克治疗的结果.方法回顾性分析1981年7月～1999年5月间收治胆道感染性休克405例.结果手术治疗302例,治愈267例,治愈率88.4%,死亡35例,病死率11.6%;非手术治疗103例,治愈61例,治愈率59.2%,死亡42例,病死率40.8%.手术治疗效果优于非手术治疗(P<0.01).术前或术后6h内纠正休克效果好(P<0.01).胆囊切除比未切除效果好(P<0.01).结论应尽快纠正休克并及时施行手术.应常规切除胆囊以利术野暴露,清除原发病灶及毒素源.胆肠吻合术并非禁忌证.

THERAPIES IN BILIARY TRACT SEPTIC SHOCK (ANALYSIS OF 405 CASES)

To evaluate effects of various therapies in biliary tract septic shock. Methods: Retrospectively analyzed the 405 cases of biliary tract septic shock treated since July 1981 to May 1999 in the authors' hospital. Results: 302 cases underwent operation, 267 patients were cured, 35 patients were dead, mortality was 11. 6%; 103 cases were treated conservatively, 61 patients were cured, mortality was 40.8%. Operation results in better effect than conservative treatment (P<0.01). Shock corrected before operation or within 6 hours after operation results in better effect than shock had not been corrected (P<0.01). Cholecystectomy reaches better result. Conclusion: Shock should be corrected as soon as possible and operation should be performed in time. Cholecystectomy should be performed routinely to eliminate the diseased part ana toxin source. Choledochoenterostomy is not contraindicatea.