CAJ | 학술논문

目的加强对老年人胆总管结石的认识,为临床诊疗工作提供参考.方法回顾性分析223例老年人胆总管结石病例,总结其临床特点和诊疗情况.结果患者临床表现中恶心、呕吐最多见(86.1％,192/223),其次为发热(84.8％,189/223)、黄疸(70.0％,156/223)、腹痛(65.0％,145/223),合并感染性休克(20.2％,45/223).大肠埃希菌(41.0％,66/161)和肺炎克雷伯菌(27.3％,44/161)为优势菌,亚胺培南、美洛配能、阿米卡星、哌拉西林/他唑巴坦和莫西沙星为敏感抗生素(敏感性＞80％).抗生素联合十二指肠乳头括约肌切开(EST)取石治疗为有效治疗方法.结论抗生素联合EST取石治疗老年人胆总管结石效果确切,值得广泛应用.
목적 가강대노년인담총관결석적인식,위림상진료공작제공삼고.방법 회고성분석223례노년인담총관결석병례,총결기림상특점화진료정황.결과 환자림상표현중악심、구토최다견(86.1％,192/223),기차위발열(84.8％,189/223)、황달(70.0％,156/223)、복통(65.0％,145/223),합병감염성휴극(20.2％,45/223).대장애희균(41.0％,66/161)화폐염극뢰백균(27.3％,44/161)위우세균,아알배남、미락배능、아미잡성、고랍서림/타서파탄화막서사성위민감항생소(민감성＞80％).항생소연합십이지장유두괄약기절개(EST)취석치료위유효치료방법.결론 항생소연합EST취석치료노년인담총관결석효과학절,치득엄범응용.
Objective To further understand choledoch stone in the elderly so as to guide the clinical work.Methods The clinical data of 223 elderly patients with choledoch stone were retrospectively analyzed.The clinical characteristic and treatments to the patients were summarized.Results The patients usually presented with nausea and vomiting (86.1％,192/223),fever (84.8％,189/223),jaundice (70.0％ 156/223),abdominal pain (65.0％,145/223) and combined septic shock (20.2％,45/223).Colibacillus (41.0％,66/161) and Klebsiella pneumoniae (27.3％,44/161) were the most predominat.Imipenem,meropenem,amikacin,piperacillin/tazobactam and moxifloxacin were sensitive antibiotics(＞ 80％).Endoscopic sphincteropapillotomy(EST) with injected sensitive antibiotics was effective treatment.Conclusion Treatment of endoscopic sphincteropapillotomy and injected sensitive antibiotics was effective for elderly patients with choledoch stone.