肝吸虫病与缩窄性十二指肠乳头炎及其经内镜治疗  

The relationship between clonorchiasis sinensis and constrictive papillitis of vater and its availability of endoscopic treatment

作　　者：常旭 刘静 杨六成[2] 李晓林[2] 

机构地区：[1]510730,广州经济技术开发区医院 [2]广东省佛山市顺德区容奇医院

出　　处：《岭南现代临床外科》2003年第1期33-35,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的 研究肝吸虫病与缩窄性乳头炎的关系,缩窄性乳头炎与肝吸虫病反复发作的关系,以及经内镜治疗的可行性。方法 开腹手术和内镜治疗肝吸虫性胆管疾病分别为101例和24例。开腹手术为胆囊切除、胆总管探查;内镜组为经十二指肠镜找到乳头,行十二指肠乳头切开(EST),然后行胆总管造影,必要时放置鼻胆管引流。结果 开腹组行T管造影,发现63.2％(36/57)出现Oddi括约肌狭窄,内镜组100％的乳头炎有不同程度的硬化表现,50％(12/24)Oddi括约肌狭窄,而同期行经内镜逆行胆管造影(ERCP)的非肝吸虫病者的硬化性乳头炎仅占8.3％(1/12)(P=0.025)。结论 肝吸虫病是引起缩窄性乳头炎的重要原因之一;缩窄性乳头炎可能是肝吸虫性胆管炎反复发作的病理基础之一;经内镜治疗安全、有效、创伤小而且住院时间短。Objective To investigate the relationship between the repeated attack of clonorchiasis sinensis and stenosed papillitis of vater and its availability of endoscopic treatment. Method From January 1997 to December 2001, 101 cases of abdominal operation (Group A) and 24 cases of endoscopic treatment (Group B) were done for clonorchiasis sinensis. The cholecystectomy and choledochotomy with exploration underwent in group A. Duodenal papillotomy and choledochography underwent in group B. If neccesary, the na-so-biliary drainage should be inserted. Results Via T tube choledochography, 36 cases (63. 2% ) of constric-tive sphincter of Oddi were confirmed in group A. The sclerotic papillitis of different degree was 100% and constrictive sphincter of Oddi was 50% (12/24) in group B. Conclusion Clonorchiasis sinensis is an important cause of constrictive papillitis of vater which can result in recurrent cholangitis. The method of endoscopic treatment is a safe, more effective, less invasive and it can shorten the time of hospitalization.

关 键 词：肝吸虫病 缩窄性乳头炎 内镜治疗 

分 类 号：R53[医药卫生—内科学]