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目的探讨老年急性重症胆管炎(ACST)的临床特点、治疗方法及预后。方法回顾性分析2001年1月-2011年6月间97例老年ACST的治疗情况。根据病情及患者和家属要求,大部分经术前规范处理后采用手术治疗,并加强术后管理;部分采用非手术治疗。结果 85例患者采用手术治疗,一期手术治愈59例,结石残留22例,死亡4例。非手术12例患者中,7例好转缓解,死亡5例。结论老年ACST患者临床表现不典型,基础病较多,耐受力差,病情较隐匿且发展快,病死率高。早期解除梗阻,充分引流胆道是治疗的关键。
Objective To investigate the clinical features, treatment and prognosis of elderly acute cholangitis (ACST). Methods The clinical data of 97 elderly patients with ACST from January 2001 to June 2011 were retrospectively analyzed. According to the condition and the requirements of patients and their families, the majority of patients were treated by preoperative specification and surgical treatment was strengthened, and postoperative management was strengthened. Non-surgical treatment was used in part. Results 85 patients were treated surgically, 59 cases were cured by one operation, 22 were residual stones and 4 died. Of the 12 non-operative patients, 7 improved and 5 died. Conclusion The clinical manifestations of elderly patients with atypical ACST atypical, more underlying disease, poor tolerance, the disease was more hidden and rapid development, high mortality. Early lifting of obstruction, the full drainage of biliary tract is the key to treatment.