Singh V, Bhalla A, Sharma N, Dheerendra P C, Agarwal R, Mahi S K
Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Dig Liver Dis. 2009 Jun;41(6):442-5. doi: 10.1016/j.dld.2008.06.012. Epub 2008 Jul 25.
BACKGROUND/AIM: Cholestatic acute viral hepatitis may have prolonged course. Pruritus is often a prominent feature and difficult to control. Sometimes it may be accompanied by severe cough. There are no reports of endoscopic nasobiliary drainage in these patients.
We prospectively evaluated the role of nasobiliary drainage in six patients with cholestatic acute viral hepatitis with intractable pruritus and accompanying severe cough in one patient in an uncontrolled study.
There were five male and one female patient with cholestatic acute viral hepatitis with intractable pruritus. One patient also had severe cough. Nasobiliary drainage relieved pruritus in all patients and patient with cough also showed marked improvement within 24h. Nasobiliary drainage also hastened the recovery in these patients.
Short-term nasobiliary drainage should be considered in patients with cholestatic acute viral hepatitis with intractable pruritus and cough for symptomatic relief. It may help in faster recovery in these patients. However, a larger randomized controlled study is warranted.
背景/目的:胆汁淤积性急性病毒性肝炎病程可能延长。瘙痒常常是一个突出症状且难以控制。有时可能伴有严重咳嗽。目前尚无关于此类患者内镜下鼻胆管引流的报道。
在一项非对照研究中,我们前瞻性评估了鼻胆管引流在6例胆汁淤积性急性病毒性肝炎伴难治性瘙痒患者及其中1例伴有严重咳嗽患者中的作用。
有5例男性和1例女性胆汁淤积性急性病毒性肝炎患者伴有难治性瘙痒。1例患者还伴有严重咳嗽。鼻胆管引流缓解了所有患者的瘙痒,伴有咳嗽的患者在24小时内也有明显改善。鼻胆管引流还加速了这些患者的康复。
对于伴有难治性瘙痒和咳嗽的胆汁淤积性急性病毒性肝炎患者,应考虑短期鼻胆管引流以缓解症状。这可能有助于这些患者更快康复。然而,有必要进行更大规模的随机对照研究。