老年胆汁淤积性黄疸临床分析

摘要

Objective To investigate the causes and clinical feature of elderly patients with cholestatic jaundice. Methods Eighty-six elderly patients with cholestatic jaundice were retrospectively analyzed from December 2005 to December 2009 and were confirmed through ullrasongraphy, CT, magnetic resonance cholangiopancreatography or endoscopic retrograde cholangio-pancreatography. Results Among 86 patients,38 cases of jaundice resulted from biliary obstruction by malignant tumor, including 24 cases of carcinoma of head of pancreas and ampullary carcinoma,ten cases of cholangiocarcinoma,four cases of primary liver cancer. There were 22 cases of valculus of bile duct, six cases of alcoholic liver disease, two cases of inflammation of bile duct, six cases of drug-induced liver disease, six cases of acute virus hepatitis E,four cases of heart-induced liver disease and one case of cytomegalovirus viral hepatitis and one case of unknown causes. Prognosis was related to the pathogeny and physical condition.Conclusion The causes of elderly obstructive jaundice is complicated and clinical symptoms is undefined.%目的 探讨老年胆汁淤积性黄疸的病因及临床特点。方法 收集2005年12月至2009年12月收治的86例就诊老年胆汁淤积性黄疸患者的临床资料进行回顾性分析，诊断均经B超、CT、磁共振胰胆管造影或经内镜逆行胰胆管造影等检查证实。结果 86例中恶性肿瘤引起的梗阻38例，其中胰头癌及壶腹癌24例、胆管癌10例、肝癌4例，胆总管结石22例，酒精性肝病6例，反复发作性胆管炎2例，药物性肝损害6例，急性戊型肝炎6例，心源性黄疸4例，巨细胞病毒性肝炎1例，原因未明1例。老年人肝外胆汁淤积性黄疸以介入治疗为主，肝内胆汁淤积性黄疸以内科综合治疗为主，预后与病因、身体状况相关。结论 老年胆汁淤积性黄疸病因复杂，临床症状不典型，应加强对老年胆汁淤积性黄疸的认识。