急性化脓性胆管炎外科的临床特征与治疗变迁

The clinical characteristics and therapeutic development on the acute suppurative cholangitis

目的 了解急性化脓性胆管炎外科治疗30年来的变化情况。方法收集我院1970年1月～1999年12月急性化脓性胆管炎手术治疗的病例共288例,从其年龄、休克率、发病原因、手术方式及治疗预后等资料分析,并按70、80及90等三个年代进行排列比较。结果 (1)青幼年下降,老年人上升;(2)胆囊穿孔、休克及病死率下降;(3)胆道蛔虫及细菌感染下降,胆结石上升。结论 随着社会的发展及医疗水平的提高,急性化脓性胆管炎的发病率及病死率均明显下降。早期诊断早期治疗,是减少其死亡及并发症的主要措施。

Objectives To study the development of surgical therapy of acute suppurative cholangitis in recent 30 years. Methods From January 1970 to December 1999, 288 cases were analyzed in the age, shock rate , cause, operative method and therapeutic result retrospectively. According to the time of 70 , 80 and 90' three decades, the all cases were compared respectively. Results 1. the cases of senile patient increased, while those of junior decreased. 2. perforation of gall-bladder, shock and mortatilty were declined. 3. Biliary ascariasis and bacterial infection decreased, and biliary stone rose. Conclusions Accompanied with social development and improvement of medical, the incidence and mortality of acute suppurative cholangitis decreased obviously. Early diagnosis and treatment are the main measures to reduce motality and complication of acute suppurative cholangitis.