肝内胆道感染致胆道出血的临床诊治  

Management of hepatic haemobilia resulting from the biliary infection

作　　者：聂磊[1] 邬善敏[1] 张训臣[1] 王竹平[1] 

机构地区：[1]武汉大学人民医院普外科,430060

出　　处：《临床外科杂志》2003年第1期20-21,共2页Journal of Clinical Surgery

摘　　要：目的　提高肝内胆道感染致胆道出血的诊治水平。方法　对 11例肝内胆管出血病例 ,应用选择性肝动脉造影、胆道造影、纤维胆道镜检等检查 ,明确胆道出血的病理特点及定位诊断 ,选择相应的治疗方法。结果　 3例患者行介入栓塞治疗 ,2例行肝左外叶切除术 ,6例行胆总管探查、T形管引流术。除 1例外 ,10例患者治愈 ,随访 2年 ,效果良好。结论　根据胆道出血的不同病理特点及定位诊断 ,结合病人的全身情况 。Objective To study the management for haemobilia from the intrahepatic biliary duct due to the biliary tract infection.Methods Selective hepatic angiography, cholangiography,fib erotic choledochscope were used to confirm the pathology and diagnosis in 11 cases. Partial liver resection, transcatheter mobilization,common bile duct exploration and T-tube drainage were performed respectively.Results Of the 11 patients,3 treated by transcatheter,2 by left external lobectomy,6 by common bile duct exploration and T-tube drainage.Definitive control of the bleeding was achieved in all the patients.No complications were observed.10 of the patients are alive and well at follow-up for 2 years.Conclusions The treatment of choice depends on the underlying pathology of haemobilia,location diagnosis and the patient's general condition. The therapeutic principle is effective for hepatic haemobilia resulting from the billiard infection.

关 键 词：胆道感染 胆道出血 诊断 治疗 

分 类 号：R657.4[医药卫生—外科学]