Clinical Treatments And Prognostic Analysis Of Acute Obstructive Suppurative Chonlangitis

Objective:To explore the clinical treatments and prognostic analysis of acuteobstructive suppurative chonlangitis(AOSC).Method:Make a collection of patients with AOSC in China-Japan unionhospital affiliated to Jilin university from Jan.2010to Dec.2012. Classifythose patients to emergency operation treatment group,emergencyPTCD+operation treatment group,emergency PTCD treatmentgroup,endoscopic treatment group and conservative treatment group.Make aretrospective analysis of different treatment groups and each group,sprognostic.Cure and death as the prognostic marker,make a single factoranalysis about the high risk factors that may influence prognosis.Results:57patients together,42patients were cured,the cure rates was84％，8patients died from multiple organ dysfunction syndrome(MODS) inhospital,7of which patents died after quit their treatments1to7days.Therewere9patients took emergency operation treatment,8of them were cured,thecure rates was88.9％,1patient died,the death rates was11.1％,the basicinformation of the only one dead were as follows:biliary tract stone,advancedage(80),hypertension,several times biliary tract infection,long medicalhistory,biliary tract was filled of purulent bile,biliary necrosis.All of the11PTCD+operation patients were cured.There were11patients treated by PTCD,10of which were cured,the cure rates was90.9％，5of which can,ttolerate surgery due to complications,other5of which were caused by tumorand can,t be removed,the above10patients were changed for better,only one ofthe11died of malignancies,the death rates was9.1％.There were8patientstreated by endoscopy,7of which were cured,the cure rates was87.5％,1ofwhich died of malignancies,the death rates was12.5％，6of which hematuriaincreased amylase and returned to normal after acid suppression and reduce theenzyme activity therapy.There were20patients conservatively treated,5ofwhich died in hospital,7of which died from criticalsickness,complications,malignancies,medical fee deficiency after got out of thehospital1to7days,8of which were cured,the cure rates was40％,one of thecured patients were caused by liver neoplasms,4of the cured patients werecaused by bile duct stone in the liver,3of the cured patients were caused byneoplasm recurrence after ERBD,all of the cured patients in this group werecaused by partial bile duct obstruction or bile duct obstruction in liver.Thesingle factor analysis about the high risk factors find that period from onsettime to admission time,caused by tumor,shock when visit a doctor andcomplications are the high risk factors that influence prognosis of AOSC.Conclusions:1.It is not recommended the drug therapy as the only treatment ofAOSC, must cooperate with surgery,embolization,endoscopic to make biliarydrainage.2. The AOCS patients made intubation tube for biliary ducts is difficult,have many complications can,t tolerate endoscopic therapy,shock,critical,must bemake PTCD as soon as possible.3.Onset to admission time,shock,complications,tumor are high risk prognosticfactors,so Early diagnose and timely treatment,treatment of shock,observationand treatment of complications are vital for the prognosis of AOSC.