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[目的]对急性梗阻性化脓性胆管炎(AOSC)内镜治疗的最佳时机进行回顾性分析。[方法]将128例AOSC患者随机分成2组,其中A组77例于入院后6h内行内镜下逆行胰胆管造影术(ERCP),B组51例于入院后6~24h行ERCP。[结果]A组生命体征及各项检验指标均较术前好转,差异有统计学意义(P<0.05);B组虽生命体征、WBC较术前改善,胆红素较术前下降,但肝损害呈进行性加重,差异无统计学意义;2组间比较,A组较B组术后恢复更为显著,差异有统计学意义(P<0.05);A组病死率为1.3%,B组病死率为15.7%。[结论]AOSC手术时机应在6h内,且内镜下治疗是安全有效的。
[Objective] To retrospectively analyze the best timing of endoscopic treatment of acute obstructive suppurative cholangitis (AOSC). [Methods] A total of 128 patients with AOSC were randomly divided into two groups. Among them, 77 patients in group A underwent endoscopic retrograde cholangiopancreatography (ERCP) 6 h after admission and 51 patients in group B received ERCP 6 to 24 h after admission. [Results] The vital signs and various test indexes of group A were better than those before operation (P <0.05). In group B, the vital signs, the improvement of WBC compared with preoperative, and the decrease of bilirubin were observed The liver damage was progressively aggravating, the difference was not statistically significant; between the two groups, the recovery of group A was more significant than that of group B, the difference was statistically significant (P <0.05); the mortality of group A was 1.3%, B The case fatality rate was 15.7%. [Conclusion] The timing of AOSC surgery should be within 6h, and endoscopic treatment is safe and effective.