成功救治误诊为重型肝炎的复杂瘀胆型肝炎1例的临床分析

Successful Diagnosis and Treatment of Cholestatic Hepatitis with Complications that Misdiagnosed as Severe Hepatitis: One Case Report

本例为 1例合并急性胆囊炎、腹膜炎的瘀胆型肝炎 ,这种有合并症的瘀胆型肝炎少见 .由于病情复杂 ,临床表现不同于单纯性瘀胆型肝炎 ,致使诊断困难 .如果不仔细分析各并发症的特点及其相互影响 ,病情变化的因果关系和治疗效果 ,采用简单的条条诊断方法 ,就容易造成误诊 .因此 ,通过分析本案例 ,总结的经验是 :临床医生要提高自己的诊治水平 ,需要加强基础知识的学习 ,学会正确的临床思维和逻辑推理的诊断方法 .同时 ,临床经验的积累也很重要 .

Objective: To summarize the clinical features of the patient with cholestatic hepatitis accompanied with acute biliaritis and biliary peritonitis, to analyze the causes of misdiagnosis and mistreatment. Methods: The patient confirmed cholestatic hepatitis hospitalized to our department in 1997, and current conditions, treatments she had gotten and outcome were recorded and analyzed. Results: The case with cholestatic hepatitis accompanied with complications is rare clinically. It is difficult to diagnose because of being very complicated of patients’ conditions and differing from general cholestatic hepatitis in clinical manifestations. It is more easy misdiagnosed only by simple diagnosis methods without analysis of clearly clinical characteristics. Conclusion: To improve diagnostic accuracy and therapeutic effectiveness, clinical physicians should hold overall medical knowledge, master diagnostic methods with cultured clinical thinking and logic reasoning are important, as well as clinical experiences.