重症急性胆管炎与胆道出血相互关系的临床诊治体会

目的:提高重症急性胆管炎并胆道出血的诊治水平。方法:对8例重症急性胆管炎并胆道出血病例临床资料进行回顾性分析。结果:8例患者均行胆总管切开和T管引流术,并使用胆道镜探察,其中肝动脉结扎术2例,术后再出血2例,经选择性肝动脉栓塞介入治疗后痊愈。7例治愈,1例死亡。结论:根据重症急性胆管炎并胆道出血的特殊病理特点及定位诊断,结合病人的全身情况,选择相应的治疗方法能显著提高肝内胆道出血的疗效。

Management of Hepatic Haemobilia Resulting from Acute Cholangitis of Severe Type

Objective：To discuss the diagnosis and treatment for haemobilia caused by acute cholangitis of severe type.Methods：A retrospective analysis was made for the clinical data of 8 cases with haemobilia caused by acute severe cholangitis.Results：Every cases received the exploration of the common bile duct and T-tube drainage,and the fiber optic choledochoscope was used to observe.In two cases the hepatic artery ligation was performed and in other two cases the bleeding occurred again.After intervention therapy of selective hepatic artery obliteration all of them recovered.From 8 cases 1 case died.Conclusion：The selection of therapies must depend on the pathologic characteristics of haemobilia,location diagnosis and the patient＇s general condition.So that this therapy may be effective for hepatic haemobilia resulting from the acute cholangitis of severe type.