Objective To explore the diagnostic and treating scheme of primary sclerotic cholangitis. Methods 24 cases of primary sclerotic cholangitis identified by radiological and pathological examinations from 1972 to 1998 were analysed retrospectively. According to Thompson, 1 case was classified as type Ⅰ, 5 cases were type Ⅱ, 10 cases were type Ⅲ and 8 cases were type Ⅳ. The operation were as follows,resection of gallbladder plus T tube drainage in 8 cases, plus Roux-en-Y anastomosis of bile duct and jejunum in 12 cases, plus U tube stent and drainage in 4 cases. Results The total mortality rate was 25% (6/24) in 2～18 years follow-up after operation. Conclusion Early diagnosis and operation may resolve the drainage of bile into the jejunum. When serious lesions and worse liver functions exist, liver transplantation should be considered.
目的 探討5例特重型胰腺炎的特點及治療方法。方法 我院2001年8月至2003年8月共收治特重型胰腺炎患者5例。其中入院后18 h內心跳、呼吸驟停3次的重癥急性胰腺炎（SAP）1例，治療以及時血液濾過和心、肺、腦復蘇為重點； SAP并發胰性腦病2例，以大劑量維生素B1的補充，或足量補給濃縮紅細胞為治療重點； 并發多個器官功能障礙的暴發性胰腺炎（FAP）2例，治療重點是血液濾過和防治多器官功能衰竭的級聯放大反應，其中1例以高滲性糖昏迷為主要表現，治療重點是內穩態的糾正，血液濾過，重要器官功能維護。結果 5例特重型胰腺炎患者均治愈，平均住院時間為32.2 d。結論 器官功能的復蘇和維護、外科ICU監護、短時血液濾過、內穩態的糾正、中西藥綜合治療及病因、對癥的個體化治療是特重型胰腺炎的重要治療措施。