97例老年急性重症胆管炎的疗效分析

目的探讨老年急性重症胆管炎(ACST)的临床特点、治疗方法及预后。方法回顾性分析2001年1月-2011年6月间97例老年ACST的治疗情况。根据病情及患者和家属要求,大部分经术前规范处理后采用手术治疗,并加强术后管理;部分采用非手术治疗。结果 85例患者采用手术治疗,一期手术治愈59例,结石残留22例,死亡4例。非手术12例患者中,7例好转缓解,死亡5例。结论老年ACST患者临床表现不典型,基础病较多,耐受力差,病情较隐匿且发展快,病死率高。早期解除梗阻,充分引流胆道是治疗的关键。

Therapeutic Effect Analysis of 97 Cases of Senile Severe Acute Cholangitis

Objective To review the clinic character,therapeutic methods and prognosis of senile severe acute cholangitis.Methods The clinical data of 97 senile patients with severe acute cholangitis from January 2001 to June 2011 were analyzed retrospectively.According to the patient’s condition and requirement,most of them received surgical treatment after a standard preoperative treatment,and followed by intensive care procedures after operation.Only a few underwent the conserve treatment.Results In all 85 cases who received surgical treatment,59 cases were completely cured,22 cases were with residual stones in their bile duct and 4 patients were dead.In the 12 cases who received the conserve treatment,7 cases relieved and 5 cases died.Conclusion The clinic manifestation of senile severe acute cholangitis is not typical.The patients usually have a poor health condition and the disease progress faster than the youth,fatality rate is high.Disengaging the obstruction earlier and biliary drain are the key points in treatment.