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本文报告41例老年胆原性休克。该病多数由胆原性脓毒症引起。最常见的原因是重症急性胆管炎(ACST)。该组病人均由胆道结石梗阻所致。病情复杂险恶,死亡率高。指出老年人的急性胆道感染,容易发生休克;胆囊易穿孔;症状和体征往往不典型,病情与临床表现不一致等,作者初步阐述了其原因和机理。主张2～4小时内积极抗感染、抗休克,纠正水电解质和酸碱失衡,完善术前各项有关检查,尽早手术治疗。对手术的原则和方式,阐明了自己的观点。老年人并存病和并发症多,使病情复杂化,造成诊断和处理上的困难。同时又往往是导致死亡的直接原因。注意加强监护和治疗可减少死亡率。对伴随的糖尿病,提出了自己的看法。
This article reports 41 cases of elderly patients with cholestatic shock. The disease is mostly caused by biliary origin sepsis. The most common cause is severe acute cholangitis (ACST). The patients were caused by obstruction of biliary stones. Complex and dangerous disease, high mortality. Pointed out that the elderly with acute biliary tract infection, prone to shock; perforation of the gallbladder; symptoms and signs are often atypical, the disease and clinical manifestations of inconsistency, the author initially explained the causes and mechanism. Advocate 2 to 4 hours active anti-infection, anti-shock, correct water and electrolyte and acid-base imbalance, improve the preoperative examination, as soon as possible surgical treatment. The principles and methods of surgery, to clarify their own point of view. The coexistence of elderly patients and complications and more complicated the situation, resulting in diagnosis and treatment difficulties. At the same time it is often the direct cause of death. Note that increased care and treatment reduce mortality. With the accompanying diabetes, put forward their own views.