CAJ | 학술논문

目的：探讨创伤或术后急性非结石胆囊炎（ acute acalculous cholecystitis ，AAC）的诊疗方法。方法对收治的27例急性非结石胆囊炎患者临床资料进行分析。结果26例行剖腹手术及1例腹腔镜手术，均顺利切除胆囊；手术及病理均证实为急性非结石性胆囊炎，确诊胆囊坏疽穿孔9例，2例死亡，并有4例不同术后并发症。结论创伤后AAC症状不典型，重视局部体征、及早发现危险因素、结合B超动态监测及CT检查明显有助于诊断，延误诊断后果严重；治疗应以手术切除为主。
목적：탐토창상혹술후급성비결석담낭염（ acute acalculous cholecystitis ，AAC）적진료방법。방법대수치적27례급성비결석담낭염환자림상자료진행분석。결과26례행부복수술급1례복강경수술，균순리절제담낭；수술급병리균증실위급성비결석성담낭염，학진담낭배저천공9례，2례사망，병유4례불동술후병발증。결론창상후AAC증상불전형，중시국부체정、급조발현위험인소、결합B초동태감측급CT검사명현유조우진단，연오진단후과엄중；치료응이수술절제위주。
Objective To investigate diagnosis and treatment of posttraumatic or psotoperative acute acalculous cholecystitis (AAC). Methods Clinical data of 27 cases of AAC were analyzed retrospectively .Results All the 27 cases were treated operatively ,operation type including cholecystectomy in 26 cases and laparoscopic cholecyctectomy ( LC) in 1 case.AAC was confirmed by pathology ,of which gangrene perforation occurred in 9 cases.Two cases died and 4 cases suffered from postoperative complications of all the patients .Con-clusions Clinical characteristics of AAC are atypic .Timely discovery of local signs and risk factors combined with B ultrasonic and CT examination contribute to accurate diagnosis of AAC .Surgery is the major treatment .