华支睾吸虫所致胆道梗阻的诊断和治疗

目的 探讨华支睾吸虫所致胆道梗阻的诊断及治疗。方法 对36例华支睾吸虫所致胆道梗阻进行回顾性分析。结果 本组36例中34例术前未能确诊,仅2例术前怀疑为寄生虫团块阻塞。36例患者经手术切开胆总管取虫和术后驱虫治疗,全部治愈出院。30例随访1～3年,无复发。结论 对病人有长期食鱼生史,出现胆道梗阻症状和体征,B超示胆总管无回声团块,CT示胆总管中等密度团块状肿物,应首先考虑诊断为华支睾吸虫引起胆道梗阻的可能。胆总管切开取虫,胆道反复用生理盐水冲洗,术后驱虫治疗,必要时用胆道镜取虫,可取得满意的疗效。

Diagnosis and treatment of biliary tract obstruction caused by clonorchis sinensis

Objective To study the diagnosis and treatment of biliary tract obstruction caused by clonorchis sinensis Methods 36 cases of biliary tract obstruction caused by clonorchis sinensis were analyzed retrospec-tively. Results Among the 36 cases, 34 cases were not confirrned before operation, and parasite mass obstruction was suspected in 2 cases before operation. After cholangiotomy, taking away chonorchis sinensis and postoperative anthelmintic treatment, all cases were cured. The l to 3 years follow-up study in 30 cases showed no recur-rence. Conclusion When a patient had a history of eating uncooked fish for a long time, showed symptoms and signs of biliary tract obstruction and with a no echo mass was found by B UItrasonagraphy and a moderate density mass by CT scan in the common bile duct, the diagnosis of biliary tract obstruction caused by clonorchis sinensis should be considered at first. To obtain a stisfactory effect, treating the biliary tract obstruction caused by clonorchis sinensis with cholangiotomy, taking away the parasite using Normai saline to flush the common bile duct repeatedly and postoperative anthelmintic treatment is very important. If neccessary, taking away the parasite through chole-dochoscope should be considered.