早期手术干预对急性重症胆管炎预后的影响

Early surgical intervention on the prognosis of severe acute cholangitis

目的：分析不同手术时机治疗急性重症胆管炎的疗效差异，为早期手术干预此类患者提供临床依据。方法：选择2014年12月～2015年12月在我院接诊的80例急性重症胆管炎患者资料进行研究，根据手术治疗时机的不同分为观察组与对照组，观察组40例患者，均为入院8h内行手术治疗，对照组40例患者，在入院8h后进行手术，比较两组患者一般临床资料、术后24h血总胆红素、直接胆红素、胆汁引流量、APACHE-Ⅱ评分以及预后情况。结果：①察组术后24h胆汁引流量、血总胆红素、直接胆红素、APACHE-Ⅱ评分与对照组相比，差异有统计学意义；②观察组并发症发生率、发生功能能障碍器官个数与住院天数明显低于对照组，差异有统计学意义；两组患者病死率差异无统计学意义。结论：早期施行手术有助于改善急性重症胆管炎的预后，提高临床治疗效果。

Objective To analyze curative effect difference of different timing of surgery in the treatment of acute severe cholangitis, Early surgical intervention for these patients and provide clinical evidence. Methods 80 cases of acute severe cholangitis from December 2014 to December 2015 in our hospital were chosen, According to the timing of surgical treatment were divided into observation group and control group, The observation group 40 patients were admitted to hospital 8h received surgical treatment, The 40 patients in the control group, 8h after surgery in the hospital, Comparison of two groups of patients with clinical data, postoperative 24h blood total bilirubin, direct bilirubin, bile drainage, APACHE-score and prognosis. Results The observation group compared postoperative 24h bile drainage, serum total bilirubin and direct bilirubin, APACHE-score and the control group, The difference was statistically significant;The complication rate of the observation group, the number of organ function can disorder and length of hospital stay was significantly lower than that of the control group, The dif-ference was statistically significant;There was no significant difference in mortality rate between the two groups. Conclusion Early implementation will help to improve the prognosis of severe acute cholangitis, Improve the clinical treatment effect.