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全肠外营养(TPN)引起的郁胆已为临床所重视,有关病因与发病机理已有综述性文章发表.本文就其诊断和防治作一综述.诊断TPN导致的郁胆、郁胆性胆囊炎或胆石症的临床表现并不具有特征性,因此,在TPN支持患者出现黄疸、肝功能异常、发热或右上腹疼痛时应考虑到这一可能性,以求及时作出诊断.由于需要TPN支持的病人多数的原有疾病较重,部分病人病情复杂,典型的胆道系统病征被掩盖,这就增加了诊断的困难性.多数情况下,郁胆的诊断有赖于常规的监测,主要包括:(1)腹部超声检查:腹部B型超声波追踪检查是最受推崇的,因为它可反复实施,效果好而且无损伤性.Pitt利用超声波作连续监测,发现一病人在首次检查时为正常图象,1个月后就见胆泥形
Total parenteral nutrition (TPN) -induced by the gall has been clinically important, the etiology and pathogenesis have been reviewed articles published in this article on its diagnosis and prevention and treatment are reviewed. Diagnosis of TPN-induced depression, gallbladder gallbladder The clinical manifestations of inflammation or cholelithiasis are not characteristic and should therefore be considered in cases of jaundice, liver dysfunction, fever or right upper quadrant pain in patients with TPN in order to make timely diagnosis due to the need for TPN support Of the patients have a heavier original disease, some patients have complicated conditions, and the typical biliary system symptoms are covered, which increases the difficulty of diagnosis.In most cases, the diagnosis of ulcer depends on routine monitoring and mainly includes: ( 1) Abdominal ultrasonography: Abdominal B-type ultrasound follow-up examination is the most respected because it can be performed repeatedly, with good results and no damage.Pitt continuous monitoring using ultrasound and found that a patient in the first examination as a normal image, After 1 month to see the bile mud shape