摘要
目的 探讨内镜治疗 70岁以上高危重症急性胆管炎 (ACST)患者的临床应用价值。方法 70岁以上高危ACST 84例 ,分成外科手术组 (n=4 8)及内镜治疗组 (n =36 ) ,观察治疗结果。结果 临床治愈 72例 ,其中手术治疗组治愈率 81 2 % ,内镜治疗组治愈率91 6 % ;与手术治疗组比较 ,内镜治疗组病死率由 18 8%降至 9 1% ,并发症发生率由 37 5 %降至 13 9% ,平均引流时间由 39 4天降至18 6天 ,总治疗时间由 4 6 2天缩短至 2 2 8天。结论 内镜治疗是高龄高危ACST患者的首选治疗方法 ,具有操作简便、微创、安全有效的特点 ,尤其适用于一般情况差、伴发多器官功能不全综合征 (MODS)以及有胆道手术史者。
objective To evaluate endoscopic surgery for high risk patients over 70 years old with severe acute cholangitis. Methods From October 1991 to October 2003, 84 high risk patients over 70 years old suffering from severe acute cholangitis were included and divided into laparotomy surgery (ST) and endoscopic surgery (ET) group. Results 80 patients were cured. The care rate was 81.2% in ST group and 91.6% in ET group. The mortality rate was lower in ET compared with ST (9.1% vs 18.8%). The rate of complication was reduced from 37.5% in ST group to 13.9% in ET group. The average duration of drainage was reduced from 49.4 days in ST group to 18.6 days in ET group. The total treatment days were shortened from 46.2 days to 22.8 days comparing ST with ET. Conclusions Endoscopic surgery should be the first choice for the senile and high risk patients with severe acute cholangitis. Endoscopic surgery was convenient, with mininal injury, safe and effective, and period of treatment was shortened, especially for elderly or critically ill patients, as well as those with MODS or previous billiary operations.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2004年第7期632-633,共2页
Medical Journal of Chinese People's Liberation Army
关键词
重症急性胆管炎
外科手术治疗
内镜治疗
老年医学
acute cholangitis of severe type (ACST)
laparotonry surgery
endoscopic surgery
geriatrics
