Liu C, Zhang J
PUMC Hospital, CAMS, Beijing.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 1995 Dec;17(6):461-5.
A retrospective review of 85 patients with acute calculous cholangitis who underwent emergency surgery (n = 85) was carried out. There were 28 men and 57 women and their mean age was 61.4 years. All patients had abdominal pain, 81% had chills and fever, 75% had clinical jaundice, and 28.2% were in shock. There were 48 severe acute cholangitis (group 1) and 37 acute cholangitis (group 2). The incidence of a positive bile culture in group 1 was 100% (28/28) and that of group 2 was 85% (17/20). The morbidity and mortality in group 1 was 43.8% and 20.8%, respectively. Five patients (13.5%) in group 2 had simple wound infection, and there was no severe complications or death. A significantly lower platelet count was documented in group 1 (86.5 +/- 40.7 x 10(9)/L) as compared with group 2 (159.9 +/- 63.9 x 10(9)/L) (P < 0.001). It is suggest that platelet count less than 90 x 10(9)/L at the time of admission or preoperation may serve as a guideline for identifying high-risk patient in early surgical intervention.
对85例行急诊手术的急性结石性胆管炎患者（n = 85）进行了回顾性研究。其中男性28例，女性57例，平均年龄61.4岁。所有患者均有腹痛，81%有寒战和发热，75%有临床黄疸，28.2%出现休克。有48例严重急性胆管炎（第1组）和37例急性胆管炎（第2组）。第1组胆汁培养阳性率为100%（28/28），第2组为85%（17/20）。第1组的发病率和死亡率分别为43.8%和20.8%。第2组有5例患者（13.5%）发生单纯伤口感染，无严重并发症或死亡。与第2组（159.9±63.9×10⁹/L）相比，第1组的血小板计数显著降低（86.5±40.7×10⁹/L）（P < 0.001）。提示入院时或术前血小板计数低于90×10⁹/L可作为早期手术干预中识别高危患者的指标。
