胆道感染与胆汁粘度变化关系的探讨  

Study of the relation between biliary infection and change of bile viscosity

作　　者：王继见[1] 高根五[1] 

机构地区：[1]重庆医科大学第二临床学院

出　　处：《肝胆胰外科杂志》1999年第3期130-133,共4页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的了解胆道感染时胆汁粘度的动态变化，为胆结石成因提供线索，为临床提供更合理的治疗计划。方法３０例Ｔ管引流的连续病员，用ＮＸ３型毛细玻管粘度计测定相对粘度，并对胆汁作需氧、厌氧培养和菌落计数。结果有菌胆汁粘度明显高于无菌胆汁，但与细菌量的多少无关。有菌胆汁中粘度明显大于术后各天，后随引流时间而逐渐下降，至６天后趋于稳定并接近正常。有菌胆汁菌落量在术后２周内不随引流时间增加而变化，直到术后第３周菌落量才有显著减少。结论有菌胆汁粘度升高，但细菌并非直接因素。胆汁中的细菌和粘度升高在胆管结石形成中起协同作用。Ｔ管引流能有效地降低胆汁粘度，而胆汁中细菌量在引流术后第３周才有显著减少，临床２周时拨除Ｔ管细菌可潜伏下来，对胆管炎和胆管结石的复发可能起作用。Objective To understand the dynamic change of bile viscosity when biliary infection and supply more theoretic bases for bile duct stone formation and more rational treatment schedule for biliary infectious patients.Methods Bile viscosity was studied with NX 3 type capillary viscometer in 30 consecutive T tube drainaged patients.Bile was cultured aerobically and anaerobically and aerobes were counted.Results Bacteritic bile viscosity increased significantly than that of non bacterium bile.There was no relation to the number of bacteria.There was a trend that bile viscosity decreased from day to day and was no change in the number of bacteria during 14 postoperative days and decreased until 21 postoperative days.Conclusion Bacteritic bile viscosity increased but bacteria were not the cause that resulted bile viscosity elevation.Bacteria and viscosity elevation co operated on bile duct stone formation.T tube drainage was able to decrease bile viscosity effectively.The number of bacteria decreased significantly until 21 postoperative days.The time that T tube is drawn out is on 14 postoperative days.Bacteria may exist in bile continuously and play a role on relapse of choledochitis and bile duct stone.

关 键 词：胆道感染 胆汁粘度 病理 

分 类 号：R657.402[医药卫生—外科学]