摘要
目的 探讨重症急性胆管炎 (ACST)病人的死亡原因及手术时机。方法 回顾性分析 48例ACST病人的治疗及预后情况。结果 死亡 6例 ,其中手术治疗死亡 3例。早期大剂量应用地塞米松治疗的病人休克得到纠正率 (80 % ,12 /15 ) ,明显高于未用地塞米松的病人 (5 0 % ,4/8)。结论 ACST病人应在出现五联征之前手术 ,对于已出现休克的病人 ,应先给予适当的保守治疗 ,病情稳定后再手术 ;贻误手术时机、严重并发症、高龄是死亡的主要原因 ;应早期大剂量应用地塞米松治疗ACST。
Objective To explore the reason of death and timing of operation in patients with ACST. Methods Retrospective analysis was made on the treatment and prognosis of 48 patients with ACST.Results Of 48 patients,6 died with death rate of 12 5%.There are 3 died from surgical management.Of 15 patients treated with dexamethasone,there are 12 patients whose shocks were corrected,while of 8 patients who were not treated with dexamethasone,only 4 patients' shocks were corrected.Conclusion Surgical treatment should be done before shock or/and mental confusion was found in patients with ACST;medical treatment should be given first to patients complicated with shock,surgery should be postponed in these cases until the shock is controlled.Missing the time of operation,being older age and severe complication are the major reasons of death.The early use of massive dose of dexamethasone is very important for the patients with ACST.
出处
《中国实用外科杂志》
CSCD
北大核心
2001年第6期356-357,共2页
Chinese Journal of Practical Surgery
