肝胆管结石对肝胆系统影响的临床与实验研究  

CLINICAL AND EXPERIMENTAL STUDY ON EFFECT OF HEPATOCHOLANGIOLITHIASIS ON HEPATOBILLARY SYSTEM

作　　者：孙学英[1] 牛军[1] 寿楠海[1] 姜希宏[1] 胡三元[1] 智绪亭[1] 刘风军[1] 

机构地区：[1]山东医科大学附属医院普外科,250012

出　　处：《中国普通外科杂志》1996年第1期18-20,63,共4页China Journal of General Surgery

摘　　要：为研究肝胆管结石对肝胆系统的影响,作者从大体、纤胆镜、光镜和电镜等不同层次对160例肝胆管结石病人的肝胆系统进行了观察。发现84例(52.5％)有胆管损害,40例有肝脏损害(25％);但在光镜和电镜观察下,几乎所有病例有肝细胞变性。为证实临床所见,作者进行了动物实验,将60只家兔分为4组:胆管胆石注入组和泥沙注入组,胆石和泥沙对肝组织的亚急性毒理实验组。结果显示,在梗阻等机械性因素相同的条件下,胆石对肝胆系统可造成更大的损害。作者认为,①肝胆管结石无论是否为肝内结石或有无梗阻均可造成肝胆系统的损害;②胆石对肝胆系统的损害除梗阻因素外,胆石内有害物质的直接作用也是重要原因。因此,肝胆管结石一经确诊应及早行有效治疗。In order to explore the effect of hepatocholangiolithiasis on hepatobiiiary system, 160 patients with gallstone were observed by using choledochofiberscope, microscope and electnonic microscope. Damage of bile ducts was found in 84 cases(52.5%) and damage of the liver in 40 cases (25% ) with naked eyes. However, denaturation of hepatocytes occured in nearly all of the cases under microscope. To testify the clinical finding, animal experiments were made in 60 rabbits including infusion of gallstone or silt into bile ducts in groupl, 2, and subacute toxiologic experiment was made by direct injection of gallstone or silt into liver tissue(group3, 4). The results showed that under same condition damage of liver and bile duct caused by gallstone is more severe than that caused by silt. The authers suggest that hepatocholangiolithiasis can damage the hepatobiiiary system no matter whether there is obstruction or not. The harmful substance of gallstones can damage liver tissue directly. So effective therapy should be given as early as possible when the dis-gnosis of hepatocholangiolithiasis is made.

关 键 词：胆石 损伤 肝胆系统 

分 类 号：R657.3[医药卫生—外科学]