胆管扩张症的病因分析  

Etiological analysis of bile duct dilatation

作　　者：吕云福[1] 伍海鹰[1] 邱庆安[1] 刘宁[1] 岳劼[1] 吴鸿飞[1] 常顺伍[1] 

机构地区：[1]海南省人民医院普通外科,海口570311

出　　处：《中华肝脏外科手术学电子杂志》2016年第6期390-393,共4页Chinese Journal of Hepatic Surgery(Electronic Edition)

摘　　要：目的探讨胆管扩张症的病因。方法回顾性分析2000年1月至2014年12月在海南省人民医院收治的1430例胆管扩张症患者临床资料。其中男876例，女554例；年龄13～85岁，中位年龄56岁。所有患者均签署知情同意书，符合医学伦理学规定。观察胆管扩张症的病因及扩张程度。采用Kruskal-Wallis秩和检验分析常见的继发性胆管扩张程度与血清TB水平的关系。结果先天性胆总管囊性扩张占6．3％（90／1430）；继发性胆管扩张占93．7％（1340／1430），其中轻度扩张占28．4％（380／1340），中度占35．8％（479／1340），重度占25．4％（341／1340），特重度占10．4％（140／1340）。常见的继发性胆管扩张症病因依次为胆总管结石、胰头癌、壶腹周围癌、肝外胆管癌和慢性胰腺炎。胆总管结石、胰头癌、壶腹周围癌、慢性胰腺炎所致的继发性胆管扩张程度与血清TB水平有关（H=29．401，9．483，9．722，11．907；P〈0．05）。结论胆管扩张症以继发性为主，常见病因依次为胆总管结石、胰头癌、壶腹周围癌、肝外胆管癌和慢性胰腺炎。胆总管结石、胰头癌、壶腹周围癌和慢性胰腺炎所致的继发性胆管扩张程度与血清TB水平有关。Objective To investigate the causes of bile duct dilatation. Methods Clinical data of 1 430 patients with bile duct dilatation who were admitted to People＇s Hospital of Hainan Province between January 2000 and December 2014 were retrospectively analyzed. Among them, 876 were males and 554 were females, aged 13-85 years old with a median age of 56 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. The causes and severity of bile duct dilatation were observed. The relationship between the degree of secondary bile duct dilatation and serum total bilirubin （TB） level was analyzed by Kruskal-Wallis rank-sum test. Results Congenital cystic dilatation of common bile duct accounted for 6.3% （90/1 430）. And secondary bile duct dilatation accounted for 93.7%（1 340/1 430）, including 28.4% （380/1 340）of mild dilatation, 35.8% （479/1 340） of moderate, 25.4%（341/1 340） of severe and 10.4%（140/1 340） of extremely severe. Common causes of secondary bile duct dilatation were common bile duct stone, pancreatic head carcinoma, periampullary carcinoma, extrahepatic cholangiocarcinoma and chronic pancreatitis, in the order. The degree of secondary bile duct dilatation induced by common bile duct stone, pancreatic head carcinoma, periampullary carcinoma and chronic pancreatitis was correlated with the serum TB level （H=29.401, 9.483, 9.722, 11.907; P〈0.05）. Conclusions Bile duct dilatation is mainly secondary. The common causes are common bile duct stone,pancreatic head carcinoma, periampullary carcinoma, extrahepatic cholangiocarcinoma and chronic pancreatitis, in the order. The degree of secondary bile duct dilatation induced by common bile duet stone, pancreatic head carcinoma, periampullary carcinoma and chronic pancreatitis is correlated with serum TB level.

关 键 词：胆管 扩张 病理性 胆总管结石 胰腺肿瘤 胆管肿瘤 胰腺炎 慢性 

分 类 号：R657.4[医药卫生—外科学]