华支睾吸虫病肝声像图表现与临床关系

Correlation between liver sonographic findings and clinical manifestations of clonorchiasis

目的探讨华支睾吸虫病致肝内胆管扩张及肝实质改变的声像图表现与临床症状和体征的关系。方法收集98例华支睾吸虫病患者的声像图及临床资料,根据声像图对肝内Ⅱ、Ⅲ级胆管扩张进行分级,并对两者关系进行分析。结果肝内Ⅱ、Ⅲ级胆管分支直径轻度扩张40例,中度扩张27例,重度扩张31例。4例肝内胆管扩张伴肝实质斑片状或结节状稍强回声灶。无明显临床症状和体征者23例均为轻度扩张,临床症状和体征明显者78例中58例为中、重度扩张为主,两者差异有统计学意义(χ2=43.57,P<0.05)。合并胆囊炎、胰腺炎、肝硬化以及胆管细胞癌及肝细胞癌患者发生中、重度胆管扩张率较合并肝内胆管结石患者发生中、重度胆管扩张率高,两者差异有统计学意义(χ2=4.873,P<0.05)。结论华支睾吸虫病致胆管扩张程度与临床表现有关,结合临床症状和体征,有助于华支睾吸虫病的诊断。

Objective To study the correlation between sonographic findings of the intrahepatic bile duct and liver and clini cal symptoms and signs of clonorchiasis.Methods The data of sonographic findings of intrahepatic bile duct and liver and clini cal symptoms and signs of 98 patients with clonorchiasis were collected and analyzed.Results There were 40 cases in light de gree of the Ⅱ,Ⅲintrahepatic bile duct dilatation,27 cases in middle degree,and 31 cases in heavy degree.There were 4 cases of intrahepatic bile duct dilatation and liver patchy or nodular lesions of slightly stronger echo.The mild expansion of intrahepatic bile duct was found in the patients with no obvious clinical signs and symptoms.The middle and heavy degrees of expansion were found in the patients with obvious clinical signs and symptoms.There were significantly difference between them（χ2 = 43.57,P 0.05）.The incidence of middle and heavy degrees of expansion in patients with cholecystitis,pancreatitis,liver cirrhosis and he patocellular carcinoma and cholangiocarcinoma was much higher than that in patients with intrahepatic bile duct stones（χ2 = 4.873,P0.05）.Conclusion Bile duct dilatation is closely correlated with the clinical symptoms and signs.This connection helps the diagnosis of clonorchiasis.