急性梗阻性化脓性胆管炎致死因素分析

The lethal factor of acute obstructive suppurative cholangitis

目的总结探讨急性梗阻性化脓性胆管炎（AOSC）死亡的相关因素。方法回顾性分析56例AOSC患者的临床资料。结果死亡6例，其中5例酸中毒，5例血小板减少，5例体温明显变化，4例合并心、肺、肾基础疾病或糖尿病，5例手术及麻醉时间≥150min，5例发病距就诊时间≥72h，18例年龄≥70岁的老年患者死亡4例。年龄≥70岁，体温≥39℃或〈36℃，合并酸中毒，血小板计数≤6．0×10^12／L，合并心、肺、肾等基础疾病或糖尿病，麻醉及手术时间≥150min，发病距就诊时间≥72h患者病死率较高，差异有统计学意义（P〈0．05）。结论年龄、体温明显异常、血小板明显减少、合并心、肺、肾等基础疾病或糖尿病、酸中毒、麻醉及手术时间过长、发病距就诊时间≥72h等是AOSC的死亡因素。

Objective To summarize and investigate the lethal factor of acute obstructive suppurative cholangitis（AOSC）. Methods The clinical data of 56 patients with AOSC were retrospectively analyzed. Results Six cases died, 5 cases with acidosis, 5 cases with thrombocytopenia and 5 cases with temperature change obviously, 4 cases with heart, lung and kidney disease or diabetes, 5 cases with operation and operation time I〉 150 rain,5 cases with from onset to treatment time ≥72 h. Eighteen cases of elderly patients ≥70 years old,4 cases died. The patients whose age≥70 years, temperature ≥39 ℃ or 〈 36 ~C, combined with acidosis, platelet counts≤6.0×10^12/L, with heart,lung, kidney diease or diabetes, time of anesthesia and operation ≥ 150 min and from onset to treatment time 1〉72 h had higher death rate （P 〈 0.05）. Conclusion Age,obvious temperature abnormalities, significantly platelet decrease, with heart, lung, kidney diease or diabetes, acidosis, long time of anesthesia and operation and from onset to treatment time ≥ 72 h are the lethal factor of AOSC.