老年重症急性胆管炎的外科治疗

Surgical treatment of ACST of elderly patients

目的 通过对 54例老年重症急性胆管炎 (ACST)的诊治资料分析，认识了老年 ACST的病理、生理和临床特点，认为对老年 ACST的治疗应在积极抗感染、抗休克短期内做好术前准备的同时，不失时机地进行早期手术。方法 对 54例老年 ACST病人进行回顾性总结。结果 手术治疗 48例，治愈 43例，死亡 5例。非手术治疗 6例，死亡 4例。结论 老年 ACST一经确诊应尽早手术治疗，有效的解除梗阻减压引流并重视围手术期的处理以达到最大救治效果，降低病死率。

Objective:To study pathology,physiology and clinical characteristic of ACST of elderly patients by analysing the diagnosis and treatment data of 54 cases of ACST and find that early operation should be given while making preoperative preparation during a short time of anti-infection and antishock.Methods:To make a retrospective summary of 54 cases of ACST of elderly patients.Results:48 cases of operative treatment include 43 cases of cure and 5 cases of death.There are 6 cases of non-operative treatment that resulted in 4 cases of death.Conclusion:As soon as ACTS is ideatified,the patients should be under operative treatment as early as possible.The effective delivery of obstruction resulted from decompression drainage and paying attention to perioperative care will lead to the best outcome and lower of case fatality rate. [