胆道镜下胆管脓絮形态的分类及临床意义

目的：阐述胆道镜下胆管脓絮的形态及其形成病理基础；阐述胆管脓絮形态及分类对纤维胆道镜（CHF）治疗的指导意义。方法：通过对CHF治疗169例病例胆管脓絮形态的观察，发现各种形态的胆管脓絮共491例次，并对之进行分类研究，描述不同类型的胆管脓絮形成的病理基础，同时以之指导CHF的治疗。结果：胆管脓絮胺其不同的形态被分为五类：慧星征，海葵絮，纱贴絮和附壁脓苔，以之指导CHF治疗胆管残留结石，残瘤线结，胆管炎等取得了较好的效果，结石取尽率为92％（未取尽的13例中3例为自动放弃治疗者），平均取石次数为3．97次。结论：胆管脓絮是胆道镜下的常见征象，不同形态脓絮的形成有不同的病理基础，了解胆管脓絮形态及分类对纤维胆道镜的探查和治疗有一定的指导作用。

CHASSIFICATION OF PURA WADDING UNDER BILIARY ENDOSCOPY AND ITS CLINICAL SIGNIFICENCE

Objective To study the pathologic basis of the form and formation of bile duct pura wadding under the biliary endoscopy as well as the guidence of the form and its classification to CHF.Mehods 169 cases treated with CHF were observed for the form of the duct pura wadding.For 491 times,duct pura wadding were found in various forms,which were classified and studied.The pathologic basis of the formation of different type of pura wadding was described so as to guide the CHF treatment.Results Duct pura were classified into five types according to the form,It's good to improve the effect of the CHF treatment of residual stones,residual thread knot and cholangitis with clearency rate of 92 per cent.(3 of 13 cases with residual stones give up automatically).Extraction of stones for 3.97 times at average.Conclusion Bile duct pura is a familiar sign under the biliary endoscopy.Pura with different forms are differed in pathologic basis.Knowledge of the form and classification of bile duct pura would be useful to guide the the ascertainment and treatment of biliary endoscopy.