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目的 探讨老年人重症急性胆管炎 (ACST)的诊断与治疗。方法 对我院 1998～ 2 0 0 2年收治的老年人ACST患者 4 3例进行回顾性分析。结果 4 3例均进行手术治疗。其中有并存病 2 7例 ,占 6 2 .79%。发生术后并发症 14例 ,占 32 .5 8%。死亡 10例 ,占 2 3.2 6 %。结论 老年ACST发病急聚、进展迅猛、并存病多、术后并发症多、病死率高。治疗中应强调早期诊断、及时施行胆道减压、通畅引流 ,有效防治胆源性休克 ,避免MOSF发生 ,积极治疗并存病、并发症 ,提高治疗效果 ,降低死亡率。
Objective To investigate the diagnosis and treatment of severe acute cholangitis (ACST) in the elderly. Methods A retrospective analysis was performed on 43 elderly patients with ACST admitted from 1998 to 2002 in our hospital. Results 43 cases were treated surgically. Among them, 27 cases were complicated with disease, accounting for 62.79%. Postoperative complications occurred in 14 cases, accounting for 32.58%. 10 cases died, accounting for 3.226%. Conclusion The incidence of ACST in elderly patients is acute, rapid progress, co-morbidities, postoperative complications and high mortality. Treatment should emphasize the early diagnosis, timely implementation of biliary decompression, unobstructed drainage, effective prevention and treatment of biliary shock, to prevent MOSF, active treatment of complications, improve the therapeutic effect and reduce mortality.