首页|期刊导航|临床肝胆病杂志|缺血性胆管病的诊断和治疗

缺血性胆管病的诊断和治疗OA

Advances in the diagnosis and treatment of ischemic cholangiopathy

中文摘要英文摘要

缺血性胆管病系胆管特异性血供障碍引发的严重临床疾病,其病因包括血管性因素和非血管性因素.发病机制聚焦于胆管周围血管丛微循环障碍及缺血再灌注损伤引发的胆管上皮坏死与纤维化.临床表现异质性高,典型症状为黄疸、腹痛及胆管炎,但乏力、发热等非特异症状常延误诊断.诊断主要依赖影像学识别特征性狭窄与微循环障碍,并辅以碱性磷酸酶、γ-谷氨酰转移酶等胆汁淤积标志物.治疗策略涵盖传统药物、内镜干预及创新技术.预后评估强调碱性磷酸酶、胆红素的动态监测及影像学分型,长期管理需制定个体化监测方案以预防并发症.

Ischemic cholangiopathy(IC)is a severe clinical condition resulting from blood supply impairment in bile ducts,and its etiology includes vascular causes and non-vascular factors.The pathogenesis of IC mainly involves microcirculatory disturbance of the peribiliary blood plexus and biliary epithelial necrosis and fibrosis induced by ischemia-reperfusion injury.The clinical manifestations of IC are highly heterogeneous.The typical symptoms include jaundice,abdominal pain,and cholangitis,while non-specific symptoms,such as fatigue and fever,often cause delays in diagnosis.The diagnosis of IC mainly relies on radiological examination for identifying characteristic stenosis and microcirculatory disturbance,assisted by cholestasis biomarkers including alkaline phosphatase and gamma-glutamyl transferase.Therapeutic strategies include conventional pharmacotherapy,endoscopic intervention,and innovative techniques.Prognostic evaluation emphasizes the dynamic monitoring of alkaline phosphatase and bilirubin and classification based on radiological examination,and long-term management requires individualized monitoring regimens to prevent complications.

胡天慧;黄志寅;魏波

四川大学华西医院消化内科,成都 610041四川大学华西医院消化内科,成都 610041四川大学华西医院消化内科,成都 610041

缺血性胆管病病理状态,体征和症状诊断治疗学预后

Ischemic CholangiopathyPathological Conditions,Signs and SymptomsDiagnosisTherapeuticsPrognosis

《临床肝胆病杂志》 2026 (4)

771-776,6

白求恩公益基金会项目(BCF-LX-XH-20221014-07) Bethune Charitable Foundation Project(BCF-LX-XH-20221014-07)

10.12449/JCH260406

评论