胆管-支气管瘘1例报道并文献复习

Report of 1 case of bile duct-bronchus fistula and literature review

探讨胆管-支气管瘘的病因、发病机制、临床表现及诊治。回顾性分析我院近年收治的1例胆管-支气管瘘临床资料及随访情况,复习相关文献进行讨论。患者经胆管-支气管瘘切除关闭、膈肌修补等手术治疗,结合抗感染、纤支镜吸痰等综合治疗,恢复良好。当患者出现咯黄色或黄绿色胆汁样痰,且存在胆管-支气管瘘的危险因素(如胆道梗阻与感染等肝胆疾病),需考虑到本病的可能;行支气管镜检查留取深部痰液进行胆红素测定有助于确诊胆管-支气管瘘。

To investigate the etiology, pathogenesis, clinical manifestations and diagnosis and treatment of bile duct- bronchus fistula. Clinical data and follow-up conditions of 1 patient with bile duct-bronchus fistula having been ad- mitted to our hospital in recent years were analyzed retrospectively and relevant literature was reviewed. Through surgi- cal treatment, such as bile duct-bronchus fistula excision and diaphragm repair, and comprehensive treatment, such as anti-infection and bronchofiberscope sputum aspiration, the patient recovered well. When patients coughed yellow or yellow green bile-like sputum and there existed risk factors of bile duct-bronchus fistula （liver and gall diseases, such as biliary tract obstruction and infection）, this disease should be considered. The implementation of bilirubin detection based on the deep sputum obtained by bronchoscopy is conducive to diagnosing bile duct-bronchus fistula.