损伤控制技术在急性化脓性梗阻性胆管炎中的应用

Damage control surgery for acute obstructive cholangitis

目的 探讨损伤控制性外科（DCS）技术治疗急性化脓性梗阻性胆管炎（AOSC）的方法和疗效.方法 回顾性分析我们2001年10月至2008年10月收治的72例AOSC患者的控制性手术和后续治疗的情况.结果 72例患者均经DCS治疗.经外科重症监护病房（SICU）复苏后,20例患者痊愈,49例接受再次确定性手术.全组痊愈67例（93.1％）,再次确定性手术后胆肠吻合口漏1例（1.4％）,胆道出血2例（2.8％）,肝断面及膈下感染3例（4.2％）,均经相应治疗痊愈；放弃后续治疗3例（4.2％）,死亡2例（2.8％）.结论 对AOSC患者应根据不同的病因,选择适当的DCS术式和再次确定性手术,其疗效是满意的.

Objective To explore the clinical efficacy of damage control surgery （DES）in the treatment of acute obstructive suppurative eholangitis （ AOSC ）. Methods The clinical data of 72 AOSC patients who were admitted to our hospitals between Oct 2001 and Oct 2008 and underwent DCS were ret- rospectively analyzed. Results Among the 72 patients ,20 were cured and 49 received re - operations after surgical intensive care unit（SICU） resuscitation. The cure rate reached 93.1%. There was choleintestinal anostomotic stoma fistula in I patient, hemobilia in 2 and subdiaphragmatie and resectional surface infections in 3 after re - operations, and these patients were eventually cured by corresponding treatments. Three patients abandoned the treatment after the operation. Mortality rate was 2.8%. Conclusion DCS is effective in the treatment of AOSC.