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病毒性肝炎较常见,临床上有几种病容易误诊为病毒性肝炎。现作一概述,并提出防止误诊的要点。 1.胆石症无痛性胆石患者,常因右上腹不适,食欲减退,血清谷丙转氨酶增高和黄疸而被误诊为病毒性肝炎。有报告胆石症误诊为病毒性肝炎高达23.84％,尤其在老年患者更易误诊。胆石症导致肝损害,除胆囊结石外,40％为胆管内结石。主要病理改变为胆管炎及胆管周围炎。肝损害的严重情况与胆结石部位有关。如结石分布在肝内外胆管,出现胆管梗阻愈早,肝损害愈严重。由于胆管梗阻,致使胆汁反流引起黄疸,当胆管内压力升高到0.3kPa(30毫米
Viral hepatitis is more common, there are several clinically misdiagnosed as viral hepatitis. I will give an overview and put forward the points to prevent misdiagnosis. 1. Cholelithiasis painless gallstones, often due to right upper quadrant discomfort, loss of appetite, elevated serum alanine aminotransferases and jaundice were misdiagnosed as viral hepatitis. There are reports of cholelithiasis misdiagnosed as viral hepatitis up to 23.84%, especially in elderly patients more easily misdiagnosed. Cholelithiasis causes liver damage, except gallbladder stones, 40% of intrahepatic stones. The main pathological changes for cholangitis and peribiliary inflammation. Serious liver damage and gallstone site. Such as stones distributed in the bile duct, bile duct obstruction earlier, the more serious liver damage. Due to bile duct obstruction, causing bile reflux caused jaundice, when the bile duct pressure increased to 0.3kPa (30 mm