中国实用外科杂志

中国实用外科杂志 ›› 2006, Vol. 26 ›› Issue (02): 1-114.

• 论著 •    

糖尿病合并急性胆管炎病人的治疗选择及预后分析

李济宇，刘璞，王雪峰，全志伟   

  1. 上海交通大学医学院附属新华医院，上海 200092
  • 收稿日期:2005-11-16 修回日期:2005-12-15 出版日期:2006-01-23 发布日期:2006-01-23
  • 通讯作者: 全志伟

Surgical choice and prognostic analysis of Acute Cholangitis Combined with Diabetes.

Li Jiyu,Liu Pu,Wang Xuefeng,et al.   

  1. Department of General Surgery,Xinhua Hospital,the Affiliated Hospital of the Medical College，Shanghai Jiaotong University,Shanghai 200092，China
  • Received:2005-11-16 Revised:2005-12-15 Online:2006-01-23 Published:2006-01-23
  • Contact: Quan Zhiwei

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摘要：

目的:观察合并糖尿病的急性胆管炎病人在手术方式选择上的差异对预后的影响。方法:回顾性分析了2003年1月到2005年10月上海交通大学医学院附属新华医院外科收治的急性胆管炎319例，根据既往有无糖尿病史以及就诊时血糖的检测情况分为糖尿病组和血糖正常组，比较不同治疗方式的疗效差异。结果:合并糖尿病185例。相比血糖正常组，合并糖尿病的病人病情复杂、住院时间长、术后其他系统感染性并发症发生率高（P<0.05），首次诊断糖尿病的病人的上述指标更为严重，控制血糖将改善上述指标。内镜治疗后的恢复时间明显短于手术治疗（P<0.05）。结论:影响合并糖尿病的急性胆管炎病人疗效的关键因素是血糖的控制。糖尿病的首次诊断是影响预后的高危因素。内镜引流术应作为此类病人首选的手术方式来降低术后并发症、提高疗效。

关键词: 糖尿病, 急性胆管炎

Abstract:

Objective:To investigate the effect on prognosis of acute cholangitis combined with diabetes using different surgical treatments. Methods:A retrospective analysis of prognosis,including release of symptoms,infectious complications,duration of hospital stay,of 319 cases from Jan.2003 to Oct. 2005 using different treatment was studied. Results:Compared with serum glucosenormal group,patients with diabetes manifested more complicated,longer duration of hospital stay,and more incidence of infectious complications (P<0.05).The firstdiagnosis of diabetes in these cases made prognosis worse.Recovery time in endoscopic therapy group was significant shorten than that in surgical group (P<0.05). Conclusion:Stable serum glucose level maintains was the key factor resulted in better prognosis of acute cholangitis combined with diabetes.While firstdetection of diabetes in this kind of cases was the high risk factor.Endoscopic drainage could be the optimal therapeutic approach to earn better prognosis with fewer complications.

Key words: Diabetes, Acute Cholangitis