重症急性胆管炎伴多器官功能障碍综合征—附33例分析

Acute cholangitis gravis with Multiple Organ Dysfunction Syndrome-with 33 cases Analysis

目的：对ACST伴MODS的发生机理、治疗及手术时机的选择和脏器功能的保护等问题进行探讨。方法：收集33例ACST伴MODS临床资料．通过统计学处理、对治疗结果进行分析。结果：手术治疗组死亡率明显低于非手术治疗组．总死亡率为27．3％。结论：“两相打击”是导致MODS发生的重要原因，而ACST病人首发MODS的是肝功能障碍；手术应在抗休克治疗的同时进行，并以减压引流为手术目的；MODS的脏器功能保护应在ACST确诊后即进行，否则影响治疗效果。

Objective: To study the mechanism,the treatment and the chance of operation of the ACST with MODS Syndrome,as well as the protection of organs. METHODS:Clinical materials of the 33 patients with the ACST with MODS Syndrome were collected. Effect of treatments were analyzed by statistics. RESULTS:The mortality rate of the group treated by operation was obvious lower than the other group by non - operation. Total mortalily rate is 27. 3%. CONCLUSIONS:Two -Way-Strike is the most important one of factors of MODS. Liver failure is the first MODS of the patient with ACST. Operation and treatments for resistence to shock must be going on at the same time. The goal of operation is decompress and drainage. The pretection of orgens should be underwayed once the ACST be made. Otherwise the effect of treatments would be influenced.