摘要
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2013年6月至2014年6月我院接诊的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8 h内行手术治疗。对照组40例患者,在入院8 h后进行手术。比较两组患者一般临床资料、术后24 h的指标(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:观察组和对照组患者的一般临床资料相比较无统计学意义(P>0.05)。观察组术后24 h的血总胆红素、直接胆红素均低于对照组,二者相比较有统计学意义(P<0.05);术后24 h观察组的胆汁引流总量多于对照组(P<0.05);术后24 h观察组的APACHE-II评分低于对照组(P<0.05)。观察组与对照组的并发症发病率分别为5.00%与20.00%,观察组的并发症发生率低于对照组(χ2=4.114 3,P=0.042 5);观察组的功能障碍的器官个数少于对照组(P<0.05);观察组的住院时间短于对照组,二者相比较有统计学意义(t=8.242 5,P<0.000 1)。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,值得临床推广。
Objective： To evaluate the influence of different surgical treatment time on prognosis of acute cholangitis of severe type（ ACST）. Methods： The medical records of 80 patients with ACST were retrospectively analyzed. According to the time of surgical treatment,they were divided into observation group（ underwent operation within 8h after admission） and control group（ underwent operation beyond 8h after admission）. Control group had 40 patients,which were done surgical treatment after 8h after hospitalized. Clinical data,after 24 h indicators（ serum total bilirubin,direct bilirubin,bile drainage,APACHE-II score） and prognosis were compared with each other. Results： The basic clinical characteristics had no significant differences between the two groups（ P〉0. 05）. After24 h of operation,serum total bilirubin,direct bilirubin and APACHE-II scores in the observation group were significant lower than those of the control group（ P〈0. 05）; the total amount of bile drainage in observation group was more compared with that in the control group（ P〈0. 05）. The incidence of complications in the observation group and control group were 5. 00% and 20. 00% respectively（ χ2= 4. 114 3,P = 0. 042 5）; the number of organ dysfunction in the observation group was less than that of the control group（ P〈0. 05）; there was a shorter hospital stay in the observation group（ t = 8. 242 5,P〈 0. 000 1）. Conclusion： Early implementation of surgery could help to improve the prognosis of ACST and improve clinical outcomes. It is worthy of promotion in clinical.
出处
《川北医学院学报》
CAS
2015年第5期686-689,共4页
Journal of North Sichuan Medical College
关键词
手术时机
急性重症胆管炎
预后
Timing of surgery
Acute cholangitis of severe type（ACST）
Prognosis
