引起黄疸的癌肿与病毒性肝炎的鉴别——附28例临床分析

Distinguishing Vital Hepatitis from the Cancers Inducing Jaundice Analysis of 28 cases.

目的为了提高对肝癌、总胆管癌、胰腺癌、壶腹癌等消化道恶性肿瘤的认识，减少误诊，以便得到早期诊断和治疗。方法通过７０年代以来被误诊为各型病毒性肝炎２８例消化道癌肿的临床分析。结果发现它们在发病年龄、临床症状、肝脏大小、谷丙转氨酶（ＡＬＴ）定量、黄疸的性质和程度、ｒ－谷氨酰转肽酶（ｒ－ＧＴ）改变以及肝硬化到肝癌等多方面的表现，尽管有不同相似之处，但彼此确有不同的临床特点。结论不同的临床特点和是否存在梗阻性黄疸（尤其肝外梗阻）是区别消化道癌肿和病毒性肝炎的重要根据。

Objective To improve the knowlledge of digestive tract cancer such as hepatoma, pancreatoma, ampulla, carcinoma etc, to reduce the misdingnosis and the patients can get correct diagnosis, and be treated in time. Methods We give out the analysis of 28 cases in which they had been get the wrong diagnosis of viral hepatitis, and the corrected diagnosis were digestive tract cancers. Results We have found that there were different clinical features indeed althongh existing the similar prsesntions in the age of illness incidence, clinical symptom, the size of liver, the alanine aminotransferase activity, the cause and degree of jaundice, the change of r GT and kind of defferent presentions from cirrhosis to the cancer of liver. Conclusion Existing obstructive jaundice specially out of liver and defferent clinical features is the main base by which we can distinguish the cancer of digestive tract from the viral heparitis.