摘要
目的探讨胆总管囊状扩张诊断方面的特点,深入对本病的认识。方法对65例胆总管囊状扩张患者临床表现和超声影像资料的总结分析。结果在65例病例中,腹痛、黄疽、呕吐出现率最高。具有“三联征”的患者比例为20%(未成年组)和40%(成年组)。出现“二联征”患者比例约为1/3。超声表现分为5种类型:A、B二型胆总管扩张程度较轻,占56.9%;C、D二型胆总管扩张程度较重,占43.1%;E型合并肝内胆管囊状扩张,占15.4%;在成年组中,C、D二型的比例较高。C、D二型中,出现黄疸的比例较高。结论胆总管囊状扩张患者中腹痛、黄疽、呕吐是最常见症状;有诊断意义的“三联征”的比例较低。“二联征”对本病的诊断有重要的提示作用。胆总管扩张程度随年龄增长而加重;扩张程度越重,越容易出现黄疽。超声是诊断本病最重要的影像学方法,超声分型有临床意义。
Objective To research the diagnostic characteristic of the cystic dilatation of the common bile duct and to have more knowledge about this disease. Methods Summarizing and analyzing the clinical and ultrasonic data of the 65 patients with cystic dilatation of the common bile duet. Results There are 65 eases of cystic dilatation of the common bile duct（ 18 males, 47 females） whose average age is 8.9 years. The 65 eases are divided to the minor group（2 months - 14 years age, 55 eases） and the adult group （ 15-45 years age, 10 eases）. The incident rate of the abdominal pain,jaundice and vorniting are the most bigh in the 65 eases. The ratio of “the triad sign”（ abdominal pain,jaundice and abdominal mass）is 20% in the minor group and is 40% in the adult group. ]＇he ratio of “the couple sign”（two symptoms or sign from abdominal pain,jaundice and abdominal mass）is 1/3 or so. The sonograms of the 65 eases have been classified to 5 types ： A and B types are lighter degrees of the cystic dilatation of the common bile duct, and the ratio is 56.9%; C and D types are serious degrees of the cystic dilatation of the common bile duet, and the ratio is 43.1% ; E type, eboledoehus cystic dilatation combine with intrahepatie bile duet cystic dilatation, the ratio is 15.4%. The ratio of C and D types is higher in the adult group. The incident rate of jaundice is higher in the C and D types. Conclusion The abdominal pain, jaundice and vomit are the most cormmon symptoms in the patients with the cystic dilatation of the common bile duct. The ratio of “the triad signs” is lower in the patients althocgh it has diagnosis signification. The ratio of serious dilatation of the common bile duct is higher in the adult patients. “The couple signs” has the important hinting effect for the diagnosis. The degree of dilatation of the common bile duct increases with the increase of patient＇s age, The more serious the degree of dilatation of the common bile duct is, the more the jaundice appears. The ultrasound is the most important image method for diagnosing this disease, and the ultrasound classifang has the clinical signification for diagnosing and treating. There are some difficulty in ultrasound diagnosis for C and D types because identification diagnosis for the two types from other diseases having the expression of abdominal cyst is needed.
出处
《中国实验诊断学》
2005年第5期721-723,共3页
Chinese Journal of Laboratory Diagnosis
关键词
胆总管囊状扩张
诊断
临床表现
超声
Cystic dilatation of the cormnon bile duct
Diagnosis
Clinical situation
Ultrasound
作者简介
杨松青（1956-），男，硕士，副教授。主要从事超声诊断研究。
