恶性梗阻性黄疸78例临床分析

Clinical Analysis of 78 Cases with Malignant Obstructive Jaundice

目的 :探讨恶性梗阻性黄疸的原因、早期诊断及有效的治疗方法 ;方法 :对经手术及病理证实的恶性梗阻性黄疸 78例的发病原因、治疗方法及手术效果等进行回顾性分析 ;结果 :恶性梗阻性黄疸的原因依次为胰头癌 (4 3 .6 % )、胆管癌(2 8.2 % )、胆囊癌 (15 .4% )、十二指肠乳头癌 (10 .3% )及其它少见原因 (2 .6 % )。早期诊断有赖于重视上腹饱胀、乏力、纳差等前驱症状 ,及时检测血清胆红素及进行彩超、CT等辅助检查 ,胰头癌可切除率为 14.7%、十二指肠乳头癌为 37.5 % ,多数病例仅行姑息性胆肠、胃肠引流术 ;结论 :恶性梗阻性黄疸的主要原因是胰头癌、胆管癌和十二指肠乳头癌 ,早期诊断是提高治愈率的关键 ,根治性手术是唯一有效的治疗方法。

Objective:To explore the causes,early diagnosis and effective managemert of malignant obstructive jaundice.Methods:Retrospective analysis on the causes,management and operative effect of 78 cases of malignant obstructive Jaundice confirmed by pathological test .Results:The causes of jaundice in turn were carcinoma of pancreatic head(43.6%),bile duct cancer(28.2%),gallbladder carcinoma(15.4%),carcinoma of duodenal nipple(10.3%) and other uncommon diseases(2.6%)。Its early diagnosis depends on paying attention to the early symptoms as such abdominal distention,fatigue and appetite,the test of serum bilirubin and examration by color ultrasound and CT.The resetable rates of carcinoma of pancreatic head and duodenal nipple cancer were 14.7% and 37.5% respectively.Most of cases only underwent drainage operations.Conclusion:The main causes of malignart obstructive jaundice were carcinoma of pancreatic head,bile duct cancer and duodenal nipple carcinoma.Early diagnosis played key role in raising curative rate.Radical operation was the only effective management.