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[黄疸鉴别诊断中的合理程序]

[Rational procedures in the differential diagnosis of jaundice].

作者信息

Busse H J, Drescher T, Letterer H, Nilius R, Zipprich B, Otto L, Rink C, Schmidt W

出版信息

Z Gesamte Inn Med. 1986 Apr 15;41(8):239-42.

PMID:3524040
Abstract

In jaundice after exclusions of prehepatic and functional hepatogenic hyperbilirubinaemias the sonography should pre-eminently be used as a riskless, economical and qualified investigation method, taking into consideration clinical and laboratory-chemical data. If sonographically the findings of an intrahepatic cholostatis are shown, in therapeutic relevance the histological clarification must follow. Only in unequivocal focal changes of the liver (perhaps thin needle puncture) further investigations are unnecessary. If there are findings of an extrahepatic cholostasis, in a not unequivocal sonographic result or before a surgical intervention further aimed investigations, such as ERCP, PTC and CT, are necessary for the exact clarification of the cause of the obstruction of the bile ducts.

摘要

在排除肝前性和功能性肝源性高胆红素血症后的黄疸病例中,考虑到临床和实验室化学数据,超声检查应优先作为一种无风险、经济且合格的检查方法。如果超声检查显示肝内胆汁淤积的表现,从治疗相关性来看,必须进行组织学澄清。只有在肝脏明确的局灶性病变(可能需要细针穿刺)时,才无需进一步检查。如果存在肝外胆汁淤积的表现,在超声检查结果不明确或手术干预之前,为了准确明确胆管梗阻的原因,需要进行进一步的针对性检查,如内镜逆行胰胆管造影(ERCP)、经皮肝穿刺胆管造影(PTC)和计算机断层扫描(CT)。

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