摘要
目的评价B超、T管造影和胆道镜检查对胆道术后残石的诊断价值。方法将2002年1月～2005年12月在该院接受胆道镜治疗的病人进行了分析,依据不同的诊断标准,分析了B超、T管造影和胆道镜对肝内和肝外胆管残余结石的诊断准确率、漏诊率、误诊率和特异度。结果对于肝内胆管残石,B超和胆道镜检查诊断准确率明显高于T管造影(P<0.01),胆道镜的诊断准确率高于B超,但无统计学意义(P>0.05)。B超、T管造影和胆道镜任两种方法联合检查比单一检查方法明显提高肝内胆管结石的诊断准确率,减少漏诊。对于肝外胆管结石,T管造影和B超+T管造影检查的诊断准确率明显高于B超,但漏诊率仍然高于40%,不能作为判断肝外胆管是否有残余结石的依据。结论B超、T管造影和胆道镜任两种方法联合检查是诊断肝内胆管残石的可靠依据。B超、T管造影和B超+T管造影检查,均不能作为判断肝外胆管是否有残余结石的依据。
[Objective] To assess reliability of B ultrasonography, T-tube cholangiography and choledochoscopy in diagnosing postoperative bile duct retained stones. [Method] The patients received choledochoscopic therapy were studied retrospectively from January 2002 to December 2005. It was analysed for diagnosis rate, missed diagnosis rate, misdiagnosis rate and specificity of B uhrasonography, T-tube cholangiography and choledochoscopy to diagnose postoperative extrahepatic and intrahepatic duct retained stones by different diagnostic standards. [Results] For intrahepatic duct stones, the diagnosis rate of B ultrasonography and choledochoscopy was higher significantly than that of T-tube cholangiography（P 〈0.01）. No statistical differences was found between choledochoscopy and B ultrasonography （P 〉0.05）. Combined examination of any two among B ultrasonography, T-tube cholangiography and choledochoscopy increased more significantly diagnosis rate than that single of them. For extrahepatic duct stones, the diagnosis rates of T-tube cholangiography and B ultrasonography＋T-tube cholangiography were higher significantly than that of B ultrasonography, but the missed diagnosis rates of any of them were higher than 40%, therefore, they could not confirm accurately if any stones existed in extrahepatic duct. [Conclusions] Combined examination of any two among B uhrasonography, T-tube cholangiography and choledochoscopy was reliable to diagnose intrahepatic duct stones. B ultrasonography, T-tube cholangiography and B ultrasonography ＋T-tube cholangiography all were not reliable to diagnose extrahepatic duct stones.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2006年第10期1511-1513,共3页
China Journal of Modern Medicine
关键词
肝内胆管结石
胆道残余结石
胆道结石诊断
Intrahepatic duct stones
Retained stones of bile duct
Diagnosis of bile duct stones
