急性重症胆管炎手术时机和死亡原因的探讨

ANALYSIS OF DEATH CAUSES AND SELECTION OF OPERATIONAL TIMING FOR PATIENTS WITH ACUTE SEVERE CHOLANGITIS

目的：探讨急性重症胆管炎的手术时机与死亡原因，方法：回顾性分析1992年6月－2000年12月收治的急性重症胆管炎136例，结果：术后临床痊愈113例，围手术期死亡23例，术后72h内死亡16例，72h以后死亡4例，总死亡率16．9％（23／136），死亡原因为多系统器官衰竭9例，DIC4例，感染性休克4例，糖尿病酮症酸中毒3例，ARDS3例，结论：急性重症胆管炎的早期判断，手术前的充分扩容治疗及手术时机与手术方式的掌握，是减少并发症和降低死亡率的关键。

Objective To evaluate timing of operation cause of death of acute cholangitis of severe type (ACST).Method From June 1992 to December 2000,136 cases with acute cholangitis of severe type were included.Results 113 patients were cured.The mortality was 16.9%.The major death cause were multiple organ dysfunction syndrome(9 cases),DIC(4 cases),infective shock(4 cases),diabetes ketosis toxicosis (3 cases),ARDS(3 cases).Conclusion Early diagnosed,and well management before operation and selecting the operative timing are the key to reducing complications and mortality rate.