68例老年性急性梗阻性化脓性胆管炎的治疗体会

Clinical experience of treatment for 68 cases of acute obstractive spesitic cholangitis in elder patients

目的探讨老年性急性梗阻性化脓性胆管炎的特点及治疗方法。方法回顾性总结该院2000年4月～2008年4月8年间,对确定诊断为老年性急性梗阻性化脓性胆管炎的病人,根据病情及患者及家属要求,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43例患者采用手术治疗,一期手术治愈31例,结石残留者7例,死亡5例。非手术治疗的25例患者中,12例好转缓解,死亡13例。结论老年患者基础病较多,耐受力差,病情较隐匿且发展快,但手术仍是治疗老年性急性梗阻性化脓性胆管炎最佳方法,围手术期的管理是影响预后的关键。

[Objective] To study clincal features and treatment strategy for acute obstractive cholangitis （AOSC） in elder patients. [Methods] 68 cases of elder patients with AOSC were diagnosed from April 2000 to April 2008 in our hospital. These cases were retrospectively studied. According to the disease severeness and patients＇ condition, the majority of these patients receieved operation after a standard preoperative treatment, and followed by intensive care procedures after operation. Only a few received conserve treatment. [Results] In the 43 cases who received operation, 31 cases completely cured after the operation, 7 cases left stone in their bile duct and 5 patients dead. In the 25 cases who received conserve treatment, 12 cases relieved and 13 cases dead. [Conclusions] Although the elder patients with AOSC usually have a poor health condition and the disease progress faster than the youth, the operation is still the best treatment choice for elder patients with acute obstractive spesitic cholangitis. The perioperative management is a key elemet for patients＇ prognosis.