110例非医源性胆道出血的临床特征以及ERCP的应用疗效  

Clinical features of 110 patients with non-iatrogenic biliary tract bleeding and curative effect of endoscopic retrograde cholangiopancreatography

作　　者：李运辉[1] 孙勇[1] 吕美丰 

机构地区：[1]山东省莱芜市人民医院,271100

出　　处：《肝脏》2014年第12期904-906,共3页Chinese Hepatology

摘　　要：目的探究110例非医源性胆道出血的临床特征以及经内镜逆行胰胆管造影术(ERCP)的应用疗效。方法选取2009年8月至2014年7月非医源性胆道出血患者110例,根据病因分为良性病因患者组19例和恶性病因患者组91例,患者均采用ERCP进行治疗,统计分析所有患者的病因、临床特征,分别对比两组患者治疗前后的临床指标。结果胆管癌是非医源性胆道出血的最常见病因,大便潜血阳性是非医源性胆道出血的最常见临床特征。与治疗前相比,良性病因非医源性胆道出血患者ERCP治疗后总胆红素、GGT、ALT、WBC、中性粒细胞比例降低,黄疸、腹痛、发热例数减少(P<0.05)。与治疗前相比,恶性病因非医源性胆道出血患者ERCP治疗后总胆红素、GGT、ALT、中性粒细胞比例降低,黄疸、腹痛、发热例数减少(P<0.05)。结论非医源性胆道出血的最常见病因为胆管癌,临床特征包括大便潜血阳性、黑便、便血、呕血。ERCP为胆道出血有效的、可行的诊断和治疗方法。Objective To explore the clinical features of 110 patients with non-iatrogenic biliary tract bleeding and curative effect of endoscopic retrograde cholangiopancreatography （ERCP）.Methods One hundred and ten patients with non-iatrogenic biliary tract bleeding from August 2009 to July 2014 in our hospital were enrolled in benign group （n=19） and malignant group （n=91 ）according to etiology.All patients were treated by ERCP and etiology treatment,whose clinical features were statistically analyzed.Clinical indicators of patients in the two groups before and after treatment were compared,respectively.Results Cholangiocarcinoma was the most common cause of non-iatrogenic biliary tract bleeding,and positive fecal occult blood was the most common clinical feature of non-iatrogenic biliary tract bleeding. Compared to before treatment,patients in benign group had lower total bilirubin,GGT,ALT,WBC and percentage of neutrophils,less jaundice,abdominal pain and fever after ERCP （P 〈0.05 ）;the same results were also observed in patients in malignant group.Conclusion Cholangiocarcinoma is the most common cause of non-iatrogenic biliary tract bleeding and its clinical features include positive fecal occult blood,melena,hematochezia and haematemesis.ERCP is an effective and feasible method of diagnosis and treatment for hemobilia.

关 键 词：胆道出血 ERCP 内镜治疗 

分 类 号：R657.4[医药卫生—外科学]