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目的:探讨急性重症胆管炎临床特点及手术治疗效果。方法:选择我院2008年10月～2011年10月急性重症胆管炎患者56例,分析其临床表现。本组患者一经确诊,即给予一般处理,改善患者术前状况,给予充分术前准备。本组所有患者均实施手术治疗。根据患者病情严重程度,实施胆总管探查术、胆囊切除术和T管引流术。本组患者中,36例患者行胆囊切除、胆总管切口取石联合T管引流术;12例患者行胆总管切开取石联合T管引流术;6例患者行胆总管空肠袢式吻合术;2例庁行单纯胆囊造瘘术。结果:本组60例患者经手术处理后,1例死亡,死于多器官功能衰竭。其余59例患者治愈出院。结论:急性重症胆管炎患者要及早明确诊断,掌握好手术时机并选择妥当的手术方式是降低患者病死率和改善患者预后的关键,值得借鉴。
Objective: To investigate the clinical features and surgical treatment of acute cholangitis. Methods: Fifty-six patients with acute cholangitis of our hospital from October 2008 to October 2011 were selected for clinical analysis. The group of patients once diagnosed, that is, to give the general treatment to improve the patient’s preoperative condition, give adequate preoperative preparation. All patients in this group are undergoing surgical treatment. According to the severity of the patient’s condition, the implementation of common bile duct exploration, cholecystectomy and T-tube drainage. Thirty-six patients underwent cholecystectomy and choledocholithotomy combined with T-tube drainage; 12 patients underwent choledocholithotomy combined with T-tube drainage; 6 patients underwent common bile duct jejunal anastomosis; 2 Case 庁 simple gallbladder ostomy. Results: After surgery, 60 patients in this group died of multiple organ failure. The remaining 59 patients were cured and discharged. Conclusion: The diagnosis of acute cholangitis should be confirmed as soon as possible. To master the operation timing and choose the appropriate surgical method is the key to reduce the patient mortality and improve the prognosis of patients.