胆道系统疾病手术患者术后胆道感染的CT诊断研究  

CT diagnosis of biliary tract infections after surgery for biliary system diseases

作　　者：胡明华[1] 翁媛英[2] 陈兰[1] 汪国余[1] 徐祖良 

机构地区：[1]台州市中心医院放射科,浙江台州318000 [2]台州市中心医院神经内科,浙江台州318000

出　　处：《中华医院感染学杂志》2016年第4期851-853,共3页Chinese Journal of Nosocomiology

基　　金：浙江省科技计划基金资助项目(2007C33028)

摘　　要：目的探讨胆道系统疾病手术患者术后胆道感染的CT影像学,以提高胆道感染的早期诊断。方法选择2010年1月-2014年12月在医院行胆道系统手术且术后发生胆道感染的35例患者临床资料,所有患者均进行上腹部增强扫描,通过多种重建方式对胆道进行重建,分析胆道感染的CT表现,总结术后胆道感染的影像学特征。结果 35例患者行胆囊手术19例、胆管手术16例;其中因结石行手术的有22例,13例为其他胆道疾病的手术;开腹手术18例、腹腔镜下手术9例、介入手术8例;CT检查发现,胆道系统结石14例占40.00%,胆管壁增厚、毛糙28例占80.00%;肝内胆管扩张24例占68.57%,肝外胆管扩张29例占82.86%,胆管狭窄3例占8.57%,肝内外胆管积气的有18例占51.43%;胆道系统外改变中出现胆囊窝积液7例占20.00%,出现腹腔积液9例占25.71%,腹腔脓肿2例占5.71%,伴有淋巴结肿大4例占11.43%。结论胆道系统疾病术后易发生胆道的再次感染,胆管壁的增厚、肝内外胆管扩张、胆管积气是术后再发胆道感染CT诊断的征象。OBJECTIVE To explore the CT features of recurrent biliary tract infections after surgery for biliary system diseases,and improve the early diagnosis of biliary tract infections.METHODS The 35 cases were proven to have biliary tract infections after surgery for biliary system diseases from Jan.2010 to Dec.2014 and were checked by contrast-enhanced CT.Biliary was reconstructed by different kinds of reconstruction methods,and all the CT images were analyzed to summarize the CT features of biliary tract infections.RESULTS There were 19 out of 35 cases that underwent gallbladder surgery and 16 cases that underwent bile duct surgery;22cases were operated because of biliary stones and 13 cases because of other diseases;and 18 cases were open surgery,9cases were laparoscopic surgery and 8cases were interventional procedures.Biliary stones were found in CT images of 14 cases accounting for 40%,gallbladder wall thickening and rough in 28 cases accounting for 80%,intrahepatic bile duct dilatation in 24 cases accounting for 68.57%,extrahepatic bile duct dilatation in 29 cases accounting for 82.86%,bile duct stenosis in 3cases accounting for 8.57%,and gas production in intra-and extra-hepatic duct in 18 cases accounting for 51.43%.In addition,gallbladder fossa fluid was found in 7patients accounting for 20%,ascite in9 cases accounting for 25.71%,abdominal abscess in 2cases accounting for 5.71%,and swollen lymph nodes in 4cases accounting for 11.43%.CONCLUSIONIt is prone to occur recurrent biliary tract infection after surgery for biliary system diseases,and the CT features for diagnosis are gallbladder wall thickening,intra-and extra-hepatic bile duct dilatation,and gas production in bile duct.

关 键 词：胆道感染 胆道系统疾病 手术 体层摄影术 X线计算机 

分 类 号：R657.4[医药卫生—外科学]