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黄疸的鉴别诊断可极为复杂,为了设计最适宜的诊断策略,必须考虑各种具体试验方法的可靠性、费用和危险性,并对各类黄疸的预后有充分认识。本文分析1002例黄疸病人的存活情况。作者过去曾报道过前500例,本文总结全部病例的主要特征。患者:年龄均>15岁,于1976年~1981年间住入Hvidovre医院。黄疸均经生化确诊。除体检和15项临床化验外,进一步作超声图、肝闪烁图、胆管直接造影(ERCP或PTC)和肝活检(经皮、腹腔镜或静脉)。多数作病理解剖。作出最后诊断前至少观察3个月。患者中1/4在观察期内死亡。随访时间从入院日起计为2~7年。主要分析限于第一次黄疸的病例,共784例,占全部病例的78%。结果:黄疸的诊断归纳成4大类:急性无梗阻性黄疸,慢性无梗阻性黄疸,良性梗阻性黄疸和恶性梗阻性黄疸。4类中包括23个诊断。每组患者分别按生存3
The differential diagnosis of jaundice can be extremely complicated. In order to design the most appropriate diagnostic strategy, the reliability, cost, and risk of various specific test methods must be considered, and the prognosis of various types of jaundice must be fully understood. This article analyzes the survival of 1002 patients with jaundice. The author has reported the first 500 cases in the past. This article summarizes the main features of all cases. Patients: All were older than 15 and lived in Hvidovre Hospital between 1976 and 1981. Astragalus are confirmed by biochemistry. In addition to physical examination and 15 clinical tests, ultrasound images, hepatic scintigraphy, direct biliary angiography (ERCP or PTC), and liver biopsy (percutaneous, laparoscopic, or venous) were performed. Most of the pathological anatomy. Take at least 3 months before making the final diagnosis. One-quarter of the patients died during the observation period. Follow-up time is from 2 to 7 years from the admission date. The main analysis was limited to the first case of jaundice, a total of 784 cases, accounting for 78% of all cases. RESULTS: The diagnosis of Astragalus was summarized in four major categories: acute non-obstructive jaundice, chronic obstructive jaundice, benign obstructive jaundice, and malignant obstructive jaundice. There are 23 diagnoses in category 4. Each group of patients according to survival 3