黑龙江明水康盈医院有限公司 151700
摘要：目的:探讨腹部超声对30例黄疸疾病的诊断与鉴别诊断分析。方法:将我院30例黄疸疾病患者进行回顾性研究。30例患者均实施腹部超声的诊断。诊断后30例患者再进行病理学检查及临床手术诊断。比较两种诊断方法的临床疗效。结果：病理学检查及临床手术结果显示,30例黄疸疾病患者中内科性黄疸15例(慢性肝炎5例,急性肝炎5例,急性结石性胆囊炎4例、急性细菌性胆管炎1例)无胆管扩张现象。外科性黄疸15例(胆管癌5例,胆囊癌5例,胆总管结石3例,胰腺癌1例,壶腹癌1例)有胆管扩张现象。而腹部超声结果,内科性黄疸16例,外科性黄疸14例,仅1例误诊。病理学检查及临床手术诊断与腹部超声比较,无显著差异(P>0.05)。结论：对黄疸疾病患者检测腹部超声水平,可帮助黄疸疾病患者治疗及恢复,充分满足黄疸疾病患者生理和心理上的需求,有助于提高疗效,对临床症状和预后的改善具有良好的促进作用，效果显著，临床诊断满意度高，值得临床推广与运用。
关键词：黄疸疾病;腹部超声检测;临床诊治
Diagnosis and differential diagnosis of 30 cases of jaundice by abdominal ultrasound
Abstract: Objective: To investigate the diagnosis and differential diagnosis of 30 cases of jaundice caused by abdominal ultrasound. Methods: A retrospective study was performed on 30 patients with jaundice disease in our hospital. A diagnosis of abdominal ultrasound was performed in all 30 patients. After diagnosis, 30 patients were followed by pathological examination and clinical surgical diagnosis. Compare the clinical efficacy of the two diagnostic methods. RESULTS: Pathological examination and clinical operation showed that there were 15 cases of internal jaundice in 30 patients with jaundice disease (5 cases of chronic hepatitis, 5 cases of acute hepatitis, 4 cases of acute calculous cholecystitis, 1 case of acute bacterial cholangitis). Biliary duct expansion. There were 15 cases of surgical jaundice (5 cases of cholangiocarcinoma, 5 cases of gallbladder carcinoma, 3 cases of common bile duct stones, 1 case of pancreatic cancer, 1 case of ampullary carcinoma) with bile duct dilatation. The results of abdominal ultrasound, 16 cases of internal jaundice, 14 cases of surgical jaundice, only 1 case was misdiagnosed. There was no significant difference between pathological examination and clinical operation diagnosis and abdominal ultrasound (P>0.05). Conclusion: The detection of abdominal ultrasound level in patients with jaundice can help the treatment and recovery of patients with jaundice, fully meet the physiological and psychological needs of patients with jaundice, help improve the curative effect, and promote the improvement of clinical symptoms and prognosis. The effect is remarkable, and the clinical diagnosis is highly satisfied, which is worthy of clinical promotion and application.
Key words: jaundice disease; abdominal ultrasound detection; clinical diagnosis and treatment
黄疸是高胆红素血症的临床表现，即血液中胆红素的增加导致皮肤，巩膜，粘膜，其他组织和体液的黄色染色[1]。根据黄疸引起的因素，分为干细胞性黄疸，溶血性黄疸和梗阻性黄疸。根据治疗，分为手术黄疸和内黄疸。本文就对腹部超声对30例黄疸疾病的诊断与鉴别诊断分析的相关情况进行介绍。
1资料与方法
1.1一般资料
选取本院2016年9月-2017年9月期间收治的黄疸疾病患者30例。对这些患者进行回顾性研究。30例患者均实施腹部超声的诊断。诊断后30例患者再进行病理学检查及临床手术诊断。比较两种诊断方法的临床疗效。30例黄疸疾病患者中，女20例；年龄39-71岁，平均（46.9±6.2）岁，病程2~7d,平均病程4.5±2.5d；男10例；年龄37-73岁，平均（47.3±6.5）岁，病程2~7d,平均病程4.5±2.5d。
1.2方法
所有患者进食时间8~12h以上进行空腹常规检查,对患者进行多位检查,平卧位、半卧位、直立位、左侧卧位必要时行右侧卧位,有助于对病变部位充分暴露。如在检查中发现胆总管末端及胰腺发生病变患者,需饮水500mL再进行检查。
采取SPSS11．0软件包进行统计学分析，计量资料用均数±标准差(x±s)表示，采用t检验和χ2检验，P＜0.05为差异有统计学意义。
2.结果
病理学检查及临床手术结果显示,30例黄疸疾病患者中内科性黄疸15例无胆管扩张现象。外科性黄疸15例有胆管扩张现象。而腹部超声结果,内科性黄疸16例,外科性黄疸14例,仅1例误诊。病理学检查及临床手术诊断与腹部超声比较,无显著差异(P>0.05)。见表1。
3.讨论
黄疸是由各种恶性和良性疾病引起的，血液中的胆红素升高。血液中胆红素的增加导致皮肤，巩膜，粘膜，其他组织和体液的黄色染色 [2-3]。它分为干细胞性黄疸，溶血性黄疸和阻塞性黄疸。梗阻性黄疸分为肝外阻塞性黄疸和肝内阻塞性黄疸。梗阻性黄疸分为4型，I型完全性梗阻，主要是胆管癌，胰腺癌，壶腹癌等最常见。II型间歇性梗阻，主要由结石，胆螨等组成。III型不完全性梗阻，主要是慢性胰腺炎和肠吻合口狭窄是最常见的。IV型肝内胆管梗阻，以胆管癌为主，肝内胆管结石最为常见。
综上所述,临床诊断人员在对黄疸疾病患者临床诊断时腹部超声检测获得良好效果,有利于预防其黄疸疾病的发生，在临床上值得推广应用。
参考文献：
[1]张英娟,齐佳杉.分析腹部超声对黄疸疾病的诊断与鉴别[J].当代医学,2018,24(15):29-30.
[2]李昊昌,乔晓娟.腹部超声对96例黄疸疾病的诊断与鉴别诊断分析[J].世界最新医学信息文摘,2015,15(15):3-4+8.
[3]张蓉.腹部超声对黄疸疾病的诊断与鉴别分析[J].中国实用医药,2014,9(19):93-94.
论文作者:韩凤星
论文发表刊物:《中国研究型医院》2018年5卷6期
论文发表时间:2019/4/8
标签：黄疸论文; 超声论文; 腹部论文; 患者论文; 疾病论文; 胆管论文; 病理学论文; 《中国研究型医院》2018年5卷6期论文;