急性重症胆管炎手术时机与预后的关系

目的探讨急性重症胆管炎的手术时机与患者预后的关系,为此类患者进行早期手术提供临床依据。方法分析北京同仁医院20012004年诊治的52例临床资料,根据其接受手术时间进行分组,统计分析不同组间的术后并发症及预后等情况的差异。结果早期手术组(入院8h内)及延期手术组(入院8h后)术后24hAPACHE-Ⅱ评分、术后24h总胆红素、平均住院时间比较,早期手术组均优于延期手术组,差异有统计学意义(P<0.05)。早期手术组并发症发生率为6.9%,明显低于延期手术组的34.6%(P<0.05),2组病死率分别为0和8.7%,差异无统计学意义。结论快速、有效的胆道减压、引流是治疗急性重症胆管炎的最有效措施,一旦明确诊断后应尽早进行胆道引流。

Analysis of Correlation between Prognostic Evaluation and the Timing of Surgical Treatment for Acute Cholangitis of Severe Type

Objective To evaluate the timing of surgery in the treatment of acute cholangitis of severe type(ACST). Methods The medical records of 52 patients with ACST were retrospectively analysed. Results The morbidity of post-operation complication and mortality of early surgical treatment (less than 8 h after admission) were 6.9% and 0, respectively, in contrast to 34.6% and 8.7% in patients who underwent delayed surgical treatment(more than 8 h after admission). The APACHE-Ⅱ, TB and DB in 24 h after operation, were lower in early surgery than in delayed surgery(P<0.05). Conclusion If the diagnosis of ACST is ascertained, we suggest that surgical treatment for ACST should be performed as early as possible.