老年急性重症胆管炎的诊治分析

<TITLE>A RETROSPECTIVE STUDY OF DIAGNOSIS AND MANAGEMENT IN ELDERLY PATIENTS WITH ACUTE CHOLANGITIS OF SEVERE TYPE

目的分析老年急性重症胆管炎的特性及提高治疗水平。方法回顾性分析1999年1月至2004年12月本科收治的56例急性重症胆管炎的临床病例。结果7例行ERCP+EST取石或ERCP放置胆道支架,余49例急诊手术,25例发生呼吸系统并发症,其中2例因ARDS死亡,3例发生急性心衰,胆总管残余结石2例,外科并发症较少发生。结论老年ACST患者器官功能衰退,术前合并症多,给诊断和治疗带来一定的困难。但只要积极术前准备,及时手术,术后加强监护,处理合并症及并发症,便可以获得良好的治疗效果。

Objective To analyze the characteristics and to increase the therapeutic effects in the elderly patients with acute cholangitis of severe type. Methods The clinical data of 56 cases of elderly patients with ACST from January 1999 to December 2004.were retrospectively reviewed. Results 7 cases underwent ERCP＋EST or deposited bracket in common bile diict, the other 49 cases underwent emergency surgical treatment, 25 cases suffered complications in respiratory system, 2 cases died by ARDS. 3 cases with heart faihu＇e. 2 cases with common bile duct residual calculi, Conclusions The elderly patients with ACST have complications of many chronic diseases, predispose to delayed diagnosis. Satisfactory results can be achieved if the indication and time for operation are selected properly, and the management of the perioperative period is much concerned as well as intensive care after the operation.