CAJ | 학술논문

目的：探究110例非医源性胆道出血的临床特征以及经内镜逆行胰胆管造影术（ERCP）的应用疗效。方法选取2009年8月至2014年7月非医源性胆道出血患者110例，根据病因分为良性病因患者组19例和恶性病因患者组91例，患者均采用 ERCP 进行治疗，统计分析所有患者的病因、临床特征，分别对比两组患者治疗前后的临床指标。结果胆管癌是非医源性胆道出血的最常见病因，大便潜血阳性是非医源性胆道出血的最常见临床特征。与治疗前相比，良性病因非医源性胆道出血患者 ERCP 治疗后总胆红素、GGT、ALT、WBC、中性粒细胞比例降低，黄疸、腹痛、发热例数减少（P ＜0．05）。与治疗前相比，恶性病因非医源性胆道出血患者 ERCP 治疗后总胆红素、GGT、ALT、中性粒细胞比例降低，黄疸、腹痛、发热例数减少（P ＜0．05）。结论非医源性胆道出血的最常见病因为胆管癌，临床特征包括大便潜血阳性、黑便、便血、呕血。ERCP 为胆道出血有效的、可行的诊断和治疗方法。
목적：탐구110례비의원성담도출혈적림상특정이급경내경역행이담관조영술（ERCP）적응용료효。방법선취2009년8월지2014년7월비의원성담도출혈환자110례，근거병인분위량성병인환자조19례화악성병인환자조91례，환자균채용 ERCP 진행치료，통계분석소유환자적병인、림상특정，분별대비량조환자치료전후적림상지표。결과담관암시비의원성담도출혈적최상견병인，대편잠혈양성시비의원성담도출혈적최상견림상특정。여치료전상비，량성병인비의원성담도출혈환자 ERCP 치료후총담홍소、GGT、ALT、WBC、중성립세포비례강저，황달、복통、발열례수감소（P ＜0．05）。여치료전상비，악성병인비의원성담도출혈환자 ERCP 치료후총담홍소、GGT、ALT、중성립세포비례강저，황달、복통、발열례수감소（P ＜0．05）。결론비의원성담도출혈적최상견병인위담관암，림상특정포괄대편잠혈양성、흑편、편혈、구혈。ERCP 위담도출혈유효적、가행적진단화치료방법。
Objective To explore the clinical features of 110 patients with non-iatrogenic biliary tract bleeding and curative effect of endoscopic retrograde cholangiopancreatography (ERCP).Methods One hundred and ten patients with non-iatrogenic biliary tract bleeding from August 2009 to July 2014 in our hospital were enrolled in benign group (n=19) and malignant group (n=91 )according to etiology.All patients were treated by ERCP and etiology treatment,whose clinical features were statistically analyzed.Clinical indicators of patients in the two groups before and after treatment were compared,respectively.Results Cholangiocarcinoma was the most common cause of non-iatrogenic biliary tract bleeding,and positive fecal occult blood was the most common clinical feature of non-iatrogenic biliary tract bleeding. Compared to before treatment,patients in benign group had lower total bilirubin,GGT,ALT,WBC and percentage of neutrophils,less jaundice,abdominal pain and fever after ERCP (P <0.05 );the same results were also observed in patients in malignant group.Conclusion Cholangiocarcinoma is the most common cause of non-iatrogenic biliary tract bleeding and its clinical features include positive fecal occult blood,melena,hematochezia and haematemesis.ERCP is an effective and feasible method of diagnosis and treatment for hemobilia.