摘要
目的探讨急性梗阻性胆管炎并血小板减少的外科治疗。方法回顾性分析2003～2006年急性梗阻性胆管炎合并血小板减少（80×10^9／L以下）的10例患者的治疗情况。10例均行胆总管切开取石术，5例急诊手术，5例延期手术。结果急诊手术患者中，1例在ICU治疗10d，血小板上升为130×10^9／L，1例术中出血、十二指肠损伤，经输血、止血、行空肠营养造瘘术治疗，血小板上升为126×10^9／L，其余3例手术顺利，血小板上升为（120～140）×10^9/L。延期手术患者术后血小板除2例年龄较大者上升为96×10^9／L，余均上升至正常范围，全部患者均成功取石。结论急性梗阻性胆管炎合并血小板减少时，患者的胆管炎分级、手术史、CT诊断合并肝硬化门脉高压脾功能亢进对决定手术时间和方式至关重要。
Objective To investigate the surgical treatment of acute obstructive cholangitis complicated with thrombocytopenia. Methods Ten cases of acute obstructive cholangitis complicated with thrombocytopenia （ less than 80 ×10^9/L） were reviewed retrospectively. All cases performed choledocholithotomy, 5 cases were in emergency operation, other 5 cases were in deferment operation. Results In emergency operation, 1 case was treated in ICU for 10 days, 1 case was treated with blood transfusion and jejunostomy for hemorrhage and duodenum injury, 3 cases finished the operation smoothly. The blood platelet increased to the normal value. In deferment operation, the blood platelet increased except for 2 elder cases （96 ×10^9/L）. All cases were taken out the stone successfully. Conclusion The cholangitis grade, operation history and computer tomography diagnosis with cirrhosis of liver, portal hypertension and splenomegaly are very important factor in deciding the operation occasion and plan in the treatment of acute obstructive cholangitis complicated with thrombocytopenia.
出处
《中国医师进修杂志（外科版）》
2006年第12期22-23,共2页
Chinese Journal of Postgraduates of Medicine
关键词
急性梗阻性胆管炎
血小板减少
治疗
Acute obstructive cholangitis
Thrombocytopenia
Treatment
