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目的探讨伴发多器官功能衰竭的急性重症胆管炎的治疗方法。方法对14例伴发多器官功能衰竭(MOF)的急性重症胆管炎(ACST)患者采取急诊内镜微创治疗,通过应用经内镜十二指肠乳头切开,机械碎石,网篮取石,气囊扩张,经鼻胆道引流,胆道内支架肠道内引流等技术及术中应用甲硝唑加庆大霉素溶液冲洗胆道等综合方法综合治疗,并对患者各项临床资料进行回顾性分析。结果14例患者全部成功实现解除胆道梗阻,清除感染源,胆汁引流通畅,MOF得到纠正,全部患者均存活。结论急诊内镜微创综合治疗对伴发多器官功能衰竭的急性重症胆管炎是有效的、安全的,是伴发多器官功能衰竭的急性重症胆管炎的首选治疗方案。
Objective To explore the treatment of acute cholangitis with multiple organ failure. Methods 14 cases of acute severe cholangitis (ACST) with multiple organ failure (MOF) were treated with emergency endoscopic minimally invasive endoscopic treatment. The endoscopic papillary dissection, mechanical gravel, , Balloon dilation, drainage through the nasal bile duct, intestinal biliary stent drainage and other techniques and intraoperative application of metronidazole plus gentamicin solution wash bile and other comprehensive treatment of integrated methods, and the clinical data of patients were retrospectively analyzed. Results All 14 patients were successful in relieving biliary obstruction, clearing source of infection, smooth bile drainage, MOF correction, and all patients surviving. Conclusions The minimally invasive emergency endoscopic minimally invasive treatment is effective and safe for acute cholangitis with multiple organ failure. It is the first choice for acute cholangitis with multiple organ failure.