试论中医下法在胆道危重症治疗抢救中的作用——123例临床分析

作者	单位
刘涛	中国医科大学附属第二医院外科
张铭琏	中国医科大学附属第二医院外科
冯丽华	中国医科大学附属第二医院外科

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中文摘要:

本文采用中医下法为主的中西医结合疗法,治疗胆道危重症 AOSC、胆源性休克、胆源性败血症共123例,收到了满意疗效。治愈好转率为85.4%,死亡恶化率为14.6%。作者认为治疗中要严密观察病情变化,必要时中转手术。

英文摘要:

About 4 years’ clinical practice of ours has proved the previous belief that once the biliary system is infected and gall stones are formed,and acute suppurative obstructive cholangitis,septicemia and infectious shock follow in the wake,surgical operation would be indispensable is no longer true.Under certain circumstances,it can be successfully treated non-operatively. In our series there are 123 severe cases with biliary infection and gall stone formation.70 cases were treated with combined traditional Chinese and western medicine chiefly with purgation therapy and 53 cases by operation.For reasons given above,the mortality in our series has dropped from 59% (in 60’s)to 10.6%(by now). The authors believe that the mechanism of purgation therapy is to ensure frequent loose stools,as a result of which clinical symptoms and signs are relieved or disappear.In combination with purgation therapy"Stone-Expelling Decoction"is given and proves very effective.Treatment with combined traditional Chinese and western medicine does not exclude surgical intervention.One has to choose the right therapy for individual cases.While employing purgation therapy,the doctors and medical workers must closely monitor the changes of the condition. When operation is needed,the patient must be referred to surgery in due course of time, operative therapy is an important and effective measure to remove obstruction,drain purulent bile, and alleviate infection.

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