CAJ | 학술논문

急性梗阻性化脓性胆管炎(AOSC)是临床中凶险的急腹症之一,又称为急性重症胆管炎.若该病合并糖尿病,其发生腹腔感染的危险性大大增加,并进一步引发胆汁漏、肠瘘等,导致生命危险.而腹腔感染的处置得当与否对患者预后非常关键.2013年5-7月解放军第四二五医院收治1例AOSC合并糖尿病患者,因家属早期拒绝手术、手术前后血糖控制不严格致反复腹腔感染、脓肿形成,引发胆汁漏、肠瘘等严重并发症.患者经3次手术、禁食、胃肠减压、肠外营养及应用生长抑素、加强抗感染等治疗后痊愈出院.
급성경조성화농성담관염(AOSC)시림상중흉험적급복증지일,우칭위급성중증담관염.약해병합병당뇨병,기발생복강감염적위험성대대증가,병진일보인발담즙루、장루등,도치생명위험.이복강감염적처치득당여부대환자예후비상관건.2013년5-7월해방군제사이오의원수치1례AOSC합병당뇨병환자,인가속조기거절수술、수술전후혈당공제불엄격치반복복강감염、농종형성,인발담즙루、장루등엄중병발증.환자경3차수술、금식、위장감압、장외영양급응용생장억소、가강항감염등치료후전유출원.
Acute obstructive suppurative cholangitis (AOSC) is one of the most serious acute abdomen.The incidence of abdominal infection is significantly improved when patients were complicated with AOSC and diabetes mellitus,and then bile leakage,intestinal fistula and even death were induced by abdominal infection.The management of abdominal infection is very important for the prognosis of patients.One patient with AOSC and diabetes mellitus was admitted to the No.425 Hospital of PLA from May to July in 2013.Recurrent abdominal infection and abscess occurred after the operation due to his family members' refusal of surgery at early period and lax control of blood glucose before and after surgery,and then bile leakage and intestinal fistula were induced.The patient underwent operation for 3 times,and was cured after receiving fasting,gastrointestinal decompression,parental nutrition,somatostatin administration and antibiotic treatment.