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近年来国内报道重症急性胆管炎(ACST)病死率为20～30％。阻碍进一步提高ACST疗效的因素很多,有待深入研究。现仅就ACST治疗中有关问题谈几点浅见。一、感染因素在重症急性胆管炎(又称急性梗阻性化脓性胆管炎)发病过程中,梗阻和细菌感染是两个最重要的因素,互相影响,形成恶性循环。其细菌学特点是:①内源性革兰氏阴性杆菌为主的肠属菌感染;②需氧和厌氧菌混合感染。
In recent years, the domestic reported severe acute cholangitis (ACST) mortality was 20 to 30%. Obstacles to further improve the efficacy of ACST many factors to be further studied. Now only talk about the ACST in the treatment of a few humble opinions. First, the infection factors in the pathogenesis of severe acute cholangitis (also known as acute obstructive suppurative cholangitis), obstruction and bacterial infection are the two most important factors that affect each other to form a vicious circle. The bacteriological features are: ① endogenous Gram-negative bacilli intestinal bacteria; ② mixed aerobic and anaerobic infections.