缺血性胆管病的诊断和治疗

胡天慧; 黄志寅; 魏波

doi:10.12449/JCH260406

缺血性胆管病的诊断和治疗

DOI: 10.12449/JCH260406

四川大学华西医院消化内科，成都 610041

基金项目:

白求恩公益基金会项目 (BCF-LX-XH-20221014-07)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：胡天慧、黄志寅负责撰写论文；魏波负责拟定写作思路，指导论文撰写并修改论文。

详细信息

通信作者:
魏波， allyooking@163.com （ORCID： 0000-0001-5438-1257）

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- 文章访问数: 13
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- 被引次数: 0
出版历程
- 收稿日期: 2026-02-26
- 录用日期: 2026-03-21
- 出版日期: 2026-04-25

Advances in the diagnosis and treatment of ischemic cholangiopathy

Department of Gastroenterology，West China Hospital，Sichuan University，Chengdu 610041，China

Research funding:

Bethune Charitable Foundation Project (BCF-LX-XH-20221014-07)

More Information

Corresponding author: WEI Bo， allyooking@163.com （ORCID： 0000-0001-5438-1257）

摘要

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。
- 缺血性胆管病 /
- 病理状态，体征和症状 /
- 诊断 /
- 治疗学 /
- 预后
Abstract: 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.
- Ischemic Cholangiopathy /
- Pathological Conditions， Signs and Symptoms /
- Diagnosis /
- Therapeutics /
- Prognosis

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