诊断为肝炎的梗阻性黄疸95例原因分析

• 作 者: 章华光
• 机 构: 上海市第七人民医院传染科
• 出 处: 新消化病学杂志
• 发表日期: 1997年02期
• 关键词: 恶性梗阻 阻性 胰腺肿瘤 胆汁郁积／诊断 肝外胆管癌 胆囊癌 黄疸病 胆道感染 波动性黄疸 影像学检查

目的分析引起梗阻性黄疸的常见原因．方法根据临床特征、相关实验室报告、Ｂ超和ＣＴ之影像学检查对我科于１９８７－１９９５年的８年间确诊的９５例梗阻性黄疸进行了病因分析．结果梗阻性黄疸９５例中，５３例为良性梗阻（５５８％），４２例为恶性梗阻（４４２％）．良性梗阻中以胆结石、胆虫症和胆道感染居多（７７３％），恶性梗阻中以胰腺癌、肝外胆管癌和胆囊癌居多（６４２％）．恶性梗阻的平均发病年龄（４７６岁）比良性梗阻（３４３岁）大．Ｂ超对良性梗阻的阳性率为９０５％（４８／５３），恶性梗阻为９５２％（４０／４２）．ＣＴ对良性和恶性梗阻分别为８２９％（３４／４１）和９３３％（２８／３０）．结论临床特征、相关实验室检查、Ｂ超和ＣＴ检查能满足梗阻性黄疸诊断的需要．

Objective To analyze the common causes of obstructive jaundice. Methods The etiological analysis of 95 obstructive jaundice diagnosed in our department from 1987 to 1995 according to clinical features, laboratory reports, B-ultrasound and CT was performed. Results Among 95 cases of obstructive jaundice, 53 cases were benign obstruction (55.8%) and 42 cases were malignant obstruction (442%). Among the benign obstructive diseases, gallstone, gallstone and biliary tract infection were the most common (773%). Malignant obstruction was mostly pancreatic cancer, extrahepatic cholangiocarcinoma and gallbladder cancer (642%). Malignant obstruction average age of onset (47.6 years) than benign obstruction (34.3 years old) larger. The positive rate of B-ultrasound in benign obstruction was 905% (48/53) and malignant obstruction was 952% (40/42). CT of benign and malignant obstruction were 82  9% (34/41) and 93  3% (28/30). Conclusion The clinical features, related laboratory tests, B-ultrasound and CT examination can meet the need of diagnosis of obstructive jaundice.