十二指肠胆汁引流术诊断隐匿型华支睾吸虫感染

目的分析以胃镜引导下十二指肠胆汁引流术诊断急匿型华支睾吸虫的效果。方法2008年5月-2009年6月以胃镜引导下十二指肠胆汁引流术，根据胆汁的颜色变化，分别留取胆总管液（A胆汁）、胆囊液（B胆汁）、肝内胆管液（C胆汁）。每管10-20ml，送检验科查找寄生虫卵。结果共行胃镜引导下十二指肠胆汁引流术27例，所有患者外周血白细胞数量正常，嗜酸性粒细胞计数及比例均高于正常，平均值分别为（0．616±0．470）×10^9/L、（9．559±1．056）％。23例胆汁中找到华支睾吸虫卵，阳性率为85．19％（23／27），其中7例A、B、c三管均发现虫卵，5例B、c管有虫卵，8例B管有虫卵，3例c管有虫卵。华支睾吸虫卵阳性者均给予吡喹酮驱虫治疗。结论胃镜引导下十二指肠胆汁引流术，能够安全、有效地收集胆汁，帮助隐匿型华支睾吸虫感染患者明确诊断。

Diagnosis of Clonorchis sinensis infection by duodenum biliary drainage aided with gastroscope

Objective To discuss the diagnosis of Clonorchis sinensis infection by duodenum biliary drainage aided with gastroscope. Methods Patients with enhanced eosinophile granulocyte in peripheral blood,fecal oval negtive,normal hepatic function and no abnormalities found by B-Ultrasound test,no conditions of allergy or parasite infection before, received duodenum billiary drainage by gastroscope in our hospital from May 2008 to June 2009. Results Twenty-seven patients received this operation and 26 patients were indigenous inhabitants in Guangzhou City or Pearl River Delta region. All the patients ate chaffy dish including 18 cases ate raw fish previously. The level of leukocyte in peripheral blood were normal,but count and proportion of eosinophile granulocyte were above normal with average value of （0.699±0.420）×10^9/L and （9.559±1.056）%. Ova of Clonorchis sinenais were detected from 23 cases with a positive rate of 85.19% and ova were observed in all three tubes of 7 cases,5 cases in tubes of B and C,8 cases in tube of B and 3 cases in tube of C. All the positive patients were treated with praziquantel. Conclusion Duodenum billiary drainage aided by gastroscope is a safe and effective method for collecting bile and diagnose of Clonorchis sinensis infection.