老年人重症急性胆管炎外科治疗31例分析

Analysis of surgical treatment of the elderly patients with ACST

目的 探讨老年重症急性胆管炎的手术时机及处理措施。方法 回顾性总结分析 31例老年重症急性胆管炎的临床特点及治疗结果。结果 手术治疗 2 6例 ,死亡 4例 ;非手术治疗 5例 ,死亡 4例。 15例休克患者早期应用大剂量地塞米松 ,13例 (86 .7%)休克纠正 ;6例休克患者未用地塞米松 ,3例 (5 0 %)缓解。结论 老年重症急性胆管炎首选手术治疗 ,对休克患者 ,应先给予适当保守治疗 ,休克好转后手术。

Objective To discuss the timing of operation and management of the elderly patients with ACST.Methods we retrogradely analysed clinical feature and treatment results of 31 elderly patients with ACST.Results 26 cases by operation and 4 cases died,5 cases by non-operation and 4 cases died too.15 cases were treated with dexamethasone,13 cases′ shocks were corrected; 6 cases were not treated with dexamethasone, 3 cases′ shocks were corrected.Conclusions operation treatment should be the first choice for elderly patients with ACST,conservative treatment should be given first to the patients complicated with shock,surgery should be postponed in these cases untile shock is controlled.The early use of massive dose of dexamethasone is very important for the elderly patients with ACST.