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初诊为急性非结石性胆囊炎的诊疗经验及误诊分析 被引量:1

Diagnosis and treatment of acute acalculous cholecystitis
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摘要 目的:探讨急性非结石性胆囊炎的诊断及治疗方法。方法从1992年9月1日到2012年9月1日的1853位急性胆囊炎的病人中,有139位被术前诊断为急性非结石性胆囊炎。其中男性83例,女性56例,年龄9~89岁,平均67.4岁。结合国内外文献,对139名急性非结石性胆囊炎病人的临床资料进行总结及分析。98例病人接受了胆囊切除术或胆囊部分切除术,5例病人同时进行了胆总管探查术。41例病人因为存在手术禁忌原因选择经皮胆囊造瘘术。结果139例病人中98例病人接受了手术治疗,41例病人因为手术禁忌证的原因未能接受胆囊切除术,而选择经皮胆囊造瘘术。手术治疗组中有4例死亡,术中及术后发现共有3例存在结石样物质;胆囊造瘘组中有6例死亡,术后有8例发现胆汁引流物中存在结石样物质。结论急性非结石性胆囊炎的诊断通常在术前和术中作出,有一定的误诊率,部分病人可以在术后的胆囊造瘘管及胆道引流管内发现钙化样物质。 Objective To explore the diagnosis and treatment of acute acalculous cholecystitis. Methods The clinical data of 139 acute acalculous cholecystitis inpatients were analyzed retrospectively.Results Among them,98 patients underwent surgery while another 41 percutaneons cholecystos-tomy because of surgical contraindications.Among 4 deaths,calculus was found in 3 patients in surgical group;among 6 deaths,calculus in 8 patients in percutaneons cholecystostomy group.Conclusions Acute acalculous cholecystitis is often misdiagnosed since some calcareous substance may be drained from gallbladder and bile duct.
出处 《腹部外科》 2015年第4期280-282,共3页 Journal of Abdominal Surgery
关键词 急性非结石性胆囊炎 诊断 治疗 Acute acalculous cholecystitis Diagnosis Therapy
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