摘要
目的:探讨我国胆管支气管瘘(BBF)患者的临床特点。方法:检索1989—2013年发表有关BBF的中文文献,提取患者的临床资料并进行汇总分析。结果:最终纳入51篇文献,共213例BBF患者。BBF患者男女比例为1.22:1,平均年龄为(50.4±11.1)岁,70.1%有既往手术史。BBF患者常见的临床表现有咳胆色素痰(96.5%)、咳嗽(94.5%)、发热(83.8%)、腹痛(79.3%)、胸闷/胸痛(76.2%)、黄疸(59.2%)、呼吸困难(13.5%);原发病因中包括胆管结石(41.8%)、肝包虫(31.0%)、胆道蛔虫(5.6%)、原发性或转移性肝脏肿瘤(5.2%)、外伤(4.7%)、肝脓肿(4.2%)、先天性病因(2.3%)、多种因素(1.9%)、其他单因素(1.9%)及胆囊结石伴胆囊穿孔(1.4%)。90.6%患者接受了外科手术治疗,总体治愈率为89.5%,好转率为3.3%,病死率为6.2%。结论:BBF较为罕见,原发病因较复杂;痰液胆色素检验及ERCP等可快速明确诊断;患者及时接受外科手术等治疗可取得良好的治愈效果。
Objective： To investigate the clinical characteristics ofbronchobiliary fistula （BBF） in Chinese patients. Methods： Chinese Literature concerning BBF published from 1989 to 2013 was searched, and the clinical data of the patients were extracted and analyzed aggregately. Results： Fifty-one papers were finally selected with a total of 213 BBF patients. In these BBF patients, the male to female sex ratio was about 1.22： 1, average age was （50.4±11.1） years old, and 70.1% of cases had previous history of surgery. The common clinical symptoms of BBF included biliptysis （96.5%）, cough （94.5%）, fever （83.8%）, abdominal pain （79.3%）, chest tightness/pain （76.2%）, jaundice （59.2%）, and dyspnea （13.5%）.＇Ihe primary causes comprised of bile duct stones （41.8%）,hepatic hydatid （31.0%）, biliary ascariasis （5.6%）,primary or metastatic liver tumors （5.2%）, trauma （4.7%）, liver abscess （4.2%）, congenital diseases （2.3%）, multipleetiological factors （1.9%） or other single etiological factor （1.9%）, and gallbladder stones with gallbladder wall perforation （1.4%）. Of the patients, 90.6% received surgical treatment, and the overall cure rate was 89.5%, improvement rate was 3.3% and mortality rate was 6.2%. Conclusion： BBF is a relatively rare condition with multiple primary causes; rapid diagnosis can be made by bilioptysis and ERCP; patients receiving timely surgical treatment may obtain a satisfactory result.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2014年第2期147-152,共6页
China Journal of General Surgery
关键词
胆瘘
支气管瘘
胆色素痰
胆结石
Biliary Fistula
Bronchial Fistula
Bilioptysis
Cholelithiasis
