目的探讨介入治疗对急性重症胰腺炎(acute severe pancreatitis,SAP)的疗效。方法将70例急性重症胰腺炎随机分为对照组(常规药物治疗)和介入组(常规药物治疗加介入治疗),比较两组住院期间的临床疗效。结果与对照组相比,介入组病死率低[2...目的探讨介入治疗对急性重症胰腺炎(acute severe pancreatitis,SAP)的疗效。方法将70例急性重症胰腺炎随机分为对照组(常规药物治疗)和介入组(常规药物治疗加介入治疗),比较两组住院期间的临床疗效。结果与对照组相比,介入组病死率低[25.7%(9/35)和5.7%(2/35),2χ=5.285,P=0.022];成人呼吸窘迫综合征发生率低[37.1%(13/35)和14.3(5/35),2χ=4.786,P=0.029];胰性脑病发生率低[34.3%(12/35)和11.4%(4/35),2χ=5.185,P=0.023];血淀粉酶恢复正常时间短[(7.6±2.1)d和(3.4±1.5)d,t=-9.628,P=0.000];住院时间短[(34.0±6.4)d和(23.5±8.9)d,t=-5.667,P=0.000];症状体征消失时间短[(18.0±2.6)d和(10.0±2.4)d,t=-13.376,P=0.000]。结论介入治疗能有效控制急性重症胰腺炎病情发展,缩短病程。展开更多
Objective To evaluate the down stream involvement of the bile duct in hepatolithiasis.Methods Mechanical damage to bile duct epithelia and long standing cholangitis as result of hepatolithiasis play an important rol...Objective To evaluate the down stream involvement of the bile duct in hepatolithiasis.Methods Mechanical damage to bile duct epithelia and long standing cholangitis as result of hepatolithiasis play an important role in the carcinogenesis of bile duct epithelia and stricture of the intra- and extra-hepatic bile duct. Macromorphological and microscopic changes in bile duct mucosa of 100 consecutive patients with hepatolithiasis were investigated using intra- or post-operative cholangioscopy. Biopsy specimens of lesions obtained during cholangioscopy were studied with immunohistochemical staining and flow cytometry to determine proliferative activity and DNA content. Five cases of well-proven cholangiocarcinoma were simultaneously studied as controls.Results Of the 100 patients, those with chronic cholangitis accounted for 86% (86/100), proliferative lesions 11% (11/100), adenomatous polyps 1% (1/100), and adenocarcinoma 2% (2/100). The obvious mucosal lesion associated with hepatolithiasis was located down-stream of the bile duct, predominantly in the hilar region, e.g. orifices of the right/left hepatic duct and common hepatic duct (73% mucosa lesions in the hilar region). The intensity of cancer embryonic antigen stain and the proliferative cell nuclear antigen index increased with the development of bile duct lesions. Aneuploid DNA presented mainly in the high degree malignant adenocarcinomas (】80% of cases).Conclusions The obvious mucosal lesions associated with hepatolithiasis were located down-stream of the bile duct, predominantly in the hilar region (73% of mucosal lesions). The proliferative activity of examined bile duct mucosa lesions increased with the development of pathological deterioration, which may contribute to the development of hilar bile duct stricture and hilar cholangiocarcinoma.展开更多
文摘目的探讨介入治疗对急性重症胰腺炎(acute severe pancreatitis,SAP)的疗效。方法将70例急性重症胰腺炎随机分为对照组(常规药物治疗)和介入组(常规药物治疗加介入治疗),比较两组住院期间的临床疗效。结果与对照组相比,介入组病死率低[25.7%(9/35)和5.7%(2/35),2χ=5.285,P=0.022];成人呼吸窘迫综合征发生率低[37.1%(13/35)和14.3(5/35),2χ=4.786,P=0.029];胰性脑病发生率低[34.3%(12/35)和11.4%(4/35),2χ=5.185,P=0.023];血淀粉酶恢复正常时间短[(7.6±2.1)d和(3.4±1.5)d,t=-9.628,P=0.000];住院时间短[(34.0±6.4)d和(23.5±8.9)d,t=-5.667,P=0.000];症状体征消失时间短[(18.0±2.6)d和(10.0±2.4)d,t=-13.376,P=0.000]。结论介入治疗能有效控制急性重症胰腺炎病情发展,缩短病程。
文摘Objective To evaluate the down stream involvement of the bile duct in hepatolithiasis.Methods Mechanical damage to bile duct epithelia and long standing cholangitis as result of hepatolithiasis play an important role in the carcinogenesis of bile duct epithelia and stricture of the intra- and extra-hepatic bile duct. Macromorphological and microscopic changes in bile duct mucosa of 100 consecutive patients with hepatolithiasis were investigated using intra- or post-operative cholangioscopy. Biopsy specimens of lesions obtained during cholangioscopy were studied with immunohistochemical staining and flow cytometry to determine proliferative activity and DNA content. Five cases of well-proven cholangiocarcinoma were simultaneously studied as controls.Results Of the 100 patients, those with chronic cholangitis accounted for 86% (86/100), proliferative lesions 11% (11/100), adenomatous polyps 1% (1/100), and adenocarcinoma 2% (2/100). The obvious mucosal lesion associated with hepatolithiasis was located down-stream of the bile duct, predominantly in the hilar region, e.g. orifices of the right/left hepatic duct and common hepatic duct (73% mucosa lesions in the hilar region). The intensity of cancer embryonic antigen stain and the proliferative cell nuclear antigen index increased with the development of bile duct lesions. Aneuploid DNA presented mainly in the high degree malignant adenocarcinomas (】80% of cases).Conclusions The obvious mucosal lesions associated with hepatolithiasis were located down-stream of the bile duct, predominantly in the hilar region (73% of mucosal lesions). The proliferative activity of examined bile duct mucosa lesions increased with the development of pathological deterioration, which may contribute to the development of hilar bile duct stricture and hilar cholangiocarcinoma.
