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作者于1996年3月～6月共收治84例慢性乙型病毒性肝炎,其中60例并发胆道感染,感染串为71.4％。 1.临床资料 84例慢性乙型肝炎合并胆系感染60例,男57例,女3例,年龄16～61岁,平均33.7岁。既往均无阻系疾患史,60例中黄疸型50例,非黄疸型10例。病情中度45例(75％),重度15例(25％)。临床表现:寒战、发热(38℃以下)6例,右上腹痛3例,右上腹不适感12例,胆囊区压痛12例。 实验室检查 白细胞总数增高(<20×10~9/L)3例,中性粒细胞数增高6例,总胆红素升高50例,总胆红素正常10例,γ-GT升高43例,AKP升高32例,两者均升高19例,B超显示:胆囊壁增厚大于3.5mm,呈慢性胆囊炎改变38例,胆总管内径增大>1.0cm,呈胆道感染改变6例。60例均行食管钡餐透视,无1例发现食管静脉曲张。
In March 1996 to June, a total of 84 cases of chronic hepatitis B were treated, of which 60 cases were complicated by biliary tract infection, the infection string was 71.4%. 1. Clinical data 84 cases of chronic hepatitis B with biliary infection in 60 cases, 57 males and 3 females, aged 16 to 61 years, mean 33.7 years old. Past history of non-obstructive diseases, 60 cases of jaundice in 50 cases, non-jaundice in 10 cases. The condition was moderate in 45 cases (75%) and severe in 15 cases (25%). Clinical manifestations: chills, fever (38 ℃ below) in 6 cases, right upper quadrant pain in 3 cases, right upper quadrant discomfort in 12 cases, gallbladder area tenderness in 12 cases. There were 3 cases of leukocyte count increase (<20 × 10 ~ 9 / L), 6 cases of increased neutrophil count, 50 cases of total bilirubin, 10 cases of normal bilirubin, γ-GT increased 43 cases, AKP increased in 32 cases, both were elevated in 19 cases, B-ultrasound showed: gallbladder wall thickening greater than 3.5mm, chronic cholecystitis was changed in 38 cases, increased common bile duct diameter> 1.0cm, biliary tract infection was changed 6 cases. 60 patients underwent esophageal barium meal fluoroscopy, no case of esophageal varices was found.