影像检查对梗阻性黄疸的诊断意义

1981～1991年间普通外科住院病人肝胆胰疾病所致的黄疸发生率为胆管癌100％,硬化性胆管炎100％胆总管下端良性狭窄87.5％。胆管结石84.2％.壶腹周围围癌70.7％,先天性胆管扩张症58.3％,肝癌侵及肝门区50.0％和胆囊疾病12.7％。256例梗阻性黄疸中胆石病最多见,占57.8％,其次是恶性肿瘤,占30.1％,良性疾病仅占12.1％。影像检查对梗阻性黄疸的诊断具有重要价值,诊断正确率可达88％以上。因此遇到黄疸患者时,应及早采用B型超声扫描,CT等无损伤性检查手段,对一些病人可补作经皮肝穿刺胆管造影术和内窥镜逆行胆管胰管造影术以排除肝细胞黄疸。

Diagnostic Importance of Image Examination in Obstructive Jaundice

The clinical data on the diseases of liver, biliary tract and pancrease dealing with obstructive jaundice from 1981 to 1991 in this hospital revealed that the rates of obstructive jaundice were 100％ in carcinoma of biliary duct, and in skleorocholangitis, 87.5％ in benign stenosis of lower part of the common bile duct, 84.2％ in choledocholithiasis, 70.7％ in carcinoma of peri-ampulla, 58.2％ in cogenital cholangiectasis, 50.0％ in hepatoma that invaded to the hepatic portal and 12.7％ in cholecystopathy, according to the 256 declining order of the rates of occuring, and that the causes of obstructive jaundice were cholelithiasis (57.8％), malignant tumour (30.1％) and other benign diseases (12.1％).The image examinations are portant and valuable in the diagnosis of obstructive jaundice, and can determine the extentness of cholangiectasis, the region and the causes of obstruct, and their diagnostic rates are higher (88.8％). Therefore, in diagnosis of the patients with jaundice, intact examinations (BUS, CT, etc.) are used first, some other examinations (PTC, ERCP, etc.) are used complementary to eliminate hepatocellular or obstructive jaundice.