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目的 探讨华支睾吸虫病所致梗阻性黄疸的临床病理特点及治疗方法 ,提高诊治水平。方法 对近年来收治的华支睾吸虫病所致梗阻性黄疸 8例病人进行回顾性总结和临床分析并文献复习。结果 8例病人均有明确食生鱼史。引起梗阻性黄疸的原因 :1例合并有肝门部胆管癌 ,1例合并胆管结石 ,5例为炎性胆管狭窄。全部病人均有嗜酸性粒细胞增多症。CT和B超检查见胆管扩张。粪便中均找到华支睾吸虫卵。 5例病人手术治疗 ,术中在胆管内发现华支睾吸虫成虫及虫卵。结论 华支睾吸虫病所致梗阻性黄疸的病因是炎性胆管狭窄、胆石症、胆管癌和成虫及虫卵阻塞胆管。食生鱼史、嗜酸性粒细胞增多症、粪便中找到华支睾吸虫卵、CT及B超特征性改变均有助于诊断。吡喹酮治疗有效。伴有胆管癌、胆结石及重症胆管炎时应及时手术
Objective To investigate the clinicopathological features and treatment of obstructive jaundice caused by Clonorchis sinensis and to improve the diagnosis and treatment. Methods Eight cases of obstructive jaundice caused by Clonorchis sinensis admitted in recent years were retrospectively reviewed and analyzed retrospectively. Results Eight patients had a clear history of raw fish. Causes of obstructive jaundice: 1 case of hilar cholangiocarcinoma, 1 case of bile duct stones, 5 cases of inflammatory bile duct stricture. All patients had eosinophilia. CT and B ultrasound examination of bile duct dilatation. Clonorchis sinensis eggs were found in the feces. Surgical treatment was performed in 5 patients. Clonorchis sinensis adults and eggs were found in the bile duct during operation. Conclusions The causes of obstructive jaundice caused by clonorchiasis are inflammatory bile duct stenosis, cholelithiasis, cholangiocarcinoma, and adult worms and obstructive bile duct obstruction. The history of eating raw fish, eosinophilia, finding Clonorchis sinensis eggs in the stool, CT and B-ultrasound features are helpful in the diagnosis. Praziquantel treatment is effective. With cholangiocarcinoma, gallstones and severe cholangitis should be timely surgery