急性重症胆管炎84例病因分析

Etiology of Acute Cholangitis of Severe Type: an Analysis of 84 Cases

目的探讨急性重症胆管炎的病因。方法回顾性分析2001年6月—2012年6月,11年间新乐市中医医院住院治疗的84例ACST农村病人的临床资料。结果 84例病人胆管结石引起的ACST占46.4%,胆管狭窄占19.1%,胆道手术占16.7%、胆道肿瘤占10.7%。胆道手术引起的ACST有上升趋势,差异有统计学意义(11.7%vs.20.0%,P=0.027<0.05)。胆道肿瘤引起的ACST中男性比例明显高于女性,差异有统计学意义(14.2%vs.3.5%,P<0.001)。老年ACST病人中胆管结石所占比例高于非老年,差异有统计学意义(72.4%vs.32.7%,P<0.001),胆道手术引起的ACST以非老年为高,差异有统计学意义(P<0.001)。结论胆管结石是ACST最常见病因;在老年ACST中其比例更高;胆道手术引起的ACST呈上升趋势;胆道肿瘤引起的ACST多见于男性;胆道手术引起的ACST多见于中青年病人。

Objective To analyze the etiology of acute cholangitis of severe type. Methods The clinical data of 84 cases of ACST hospitalized from June 2001 to June 2012 at Xinle city in hebei province hospital of traditional Chinese medicine were analyzed retrospectively. Results Gallstones ACST, biliary stricture ACST, biliary surgery ACST and bile duct cancer ACST was accounted for（46.4%）,（19.1%）,（16.7%）,（10.7%） respectively. There was an ascending trend in biliary surgery ACST（11.7% vs.20.0%,P=0.027 0.05）. Male was significantly more than female in bile duct cancer ACST（14.2% vs.3.5%,P〈0.001）. The proportion of Gallstones ACST in the elderly was higher than that in the non-elderly（72.4% vs.32.7%,P〈0.001）. The proportion of biliary surgery ACST in the non-elderly was higher than that in the elderly（P〈0.001）. Conclusion Gallstones factor is the most common etiology of ACST. The proportion of Gallstones ACST in the elderly is higher than that in the non-elderly. With time changed,there is an ascending trend in biliary surgery ACST. Bile duct cancer ACST is mainly in male. The cases of biliary surgery ACST is mainly in the non-elderly.