新生儿肝外胆道囊性病变的诊断与治疗
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摘要
目的:对新生儿肝外胆道囊性病变的诊断与治疗情况进行分析。方法:以新生儿肝外胆道囊性病变患者为研究对象,例数为10例,时间为2016年8月至2018年5月,对术中胆道造影、腹腔镜、CT、B超、肝功能以及临床表现等进行观察分析。结果:两组患者肝功能指标水平差异无统计学意义(P> 0.05);胆总管囊肿患者的胆囊宽、胆囊长、囊肿宽、囊肿长均大于胆道闭锁患者,差异有统计学意义(P <0.01)。结论:新生儿多种胆道畸形均可使其出现肝外胆道囊性病变的表现,实施术中腹腔镜以及B超检查,可较好对新生儿肝外胆道囊性病变进行鉴别诊断,为其疾病的治疗提供依据。
Objective: To analyze the diagnosis and treatment of extrahepatic biliary cystic lesions in neonates. Methods: A total of10 neonatal patients with extrahepatic biliary cystic lesions were studied from August 2016 to May 2018. Intraoperative biliary angiography, laparoscopy, CT, B-ultrasound, liver function and clinical manifestations were observed and analyzed. Results: There was no statistically significant difference in liver function between the two groups(P >0.05). The gallbladder width, gallbladder length, cyst width and cyst length of the patients with choledochocyst were all larger than the patients with biliary atresia, and the differences were statistically significant(P<0.01). Conclusion: A variety of biliary malformations in neonates can cause the appearance of extrahepatic biliary cystic lesions. Intraoperative laparoscopy and B-ultrasound examination can be used for the differential diagnosis of extrahepatic biliary cystic lesions in neonates, providing a basis for the treatment of the disease.
Objective: To analyze the diagnosis and treatment of extrahepatic biliary cystic lesions in neonates. Methods: A total of10 neonatal patients with extrahepatic biliary cystic lesions were studied from August 2016 to May 2018. Intraoperative biliary angiography, laparoscopy, CT, B-ultrasound, liver function and clinical manifestations were observed and analyzed. Results: There was no statistically significant difference in liver function between the two groups(P >0.05). The gallbladder width, gallbladder length, cyst width and cyst length of the patients with choledochocyst were all larger than the patients with biliary atresia, and the differences were statistically significant(P<0.01). Conclusion: A variety of biliary malformations in neonates can cause the appearance of extrahepatic biliary cystic lesions. Intraoperative laparoscopy and B-ultrasound examination can be used for the differential diagnosis of extrahepatic biliary cystic lesions in neonates, providing a basis for the treatment of the disease.
引文
[1]吴喜珍.多排螺旋CT、MRI在诊断肝外胆道梗阻性病变中价值比较分析[J].影像研究与医学应用,2018,2(11):63-65.
[2]施诚仁.先天性胆道闭锁临床研究现状[J].实用儿科临床杂志,2008,23(23):1802-1803.
[3]彭淑牖,史留斌,彭承宏,等.108例先天性胆管囊肿的诊治经验[J].中华外科杂志,2001,39(12):915-917.
[4]刁美,林海伟,明安晓,等.先天性胆管扩张症的病因病理及分型研究[J].中华小儿外科杂志,2012,33(4):249-253.
[5]付康,李丹丹,冯杰雄.2017年北美及欧洲儿科胃肠肝脏病和营养学会婴儿胆汁淤积性黄疸评估指南的胆道闭锁评估解读[J].中华小儿外科杂志,2017,38(7):495-499.
[6]蒋宏,刘钧澄.胆道闭锁的早期诊断及误诊原因分析[J].临床小儿外科杂志,2015,14(1):7-9.
[7]董淳强,杨体泉,董昆.胆道闭锁术后早期胆管炎风险因素分析[J].临床小儿外科杂志,2013,12(5):348-353.
[8]谭书德,刘敏,李恩春,等.胆道扩张的形态学MR表现对胆道梗阻性病变的诊断分析[J].医学影像学杂志,2017,27(5):844-847.
[9]周静,张煜,罗志建,等.超声造影诊断肝外胆道梗阻性病变应用研究[J].中国超声医学杂志,2014,30(12):1102-1105.
[10]吴薇,黄志华,董永绥,等.肝组织病理学检查在肝外胆道闭锁与婴儿肝炎综合征鉴别诊断中的意义[J].临床儿科杂志,2009,27(10):912-915.
[11]郑珊.胆道闭锁的规范化诊断和治疗进展[J].临床小儿外科杂志,2012,11(4):241-243.
[12]陈娟,杨蕾,郑忠梅,等.胆道闭锁53例临床特点与误诊分析[J].实用儿科临床杂志,2010,25(23):1808-1809.
[2]施诚仁.先天性胆道闭锁临床研究现状[J].实用儿科临床杂志,2008,23(23):1802-1803.
[3]彭淑牖,史留斌,彭承宏,等.108例先天性胆管囊肿的诊治经验[J].中华外科杂志,2001,39(12):915-917.
[4]刁美,林海伟,明安晓,等.先天性胆管扩张症的病因病理及分型研究[J].中华小儿外科杂志,2012,33(4):249-253.
[5]付康,李丹丹,冯杰雄.2017年北美及欧洲儿科胃肠肝脏病和营养学会婴儿胆汁淤积性黄疸评估指南的胆道闭锁评估解读[J].中华小儿外科杂志,2017,38(7):495-499.
[6]蒋宏,刘钧澄.胆道闭锁的早期诊断及误诊原因分析[J].临床小儿外科杂志,2015,14(1):7-9.
[7]董淳强,杨体泉,董昆.胆道闭锁术后早期胆管炎风险因素分析[J].临床小儿外科杂志,2013,12(5):348-353.
[8]谭书德,刘敏,李恩春,等.胆道扩张的形态学MR表现对胆道梗阻性病变的诊断分析[J].医学影像学杂志,2017,27(5):844-847.
[9]周静,张煜,罗志建,等.超声造影诊断肝外胆道梗阻性病变应用研究[J].中国超声医学杂志,2014,30(12):1102-1105.
[10]吴薇,黄志华,董永绥,等.肝组织病理学检查在肝外胆道闭锁与婴儿肝炎综合征鉴别诊断中的意义[J].临床儿科杂志,2009,27(10):912-915.
[11]郑珊.胆道闭锁的规范化诊断和治疗进展[J].临床小儿外科杂志,2012,11(4):241-243.
[12]陈娟,杨蕾,郑忠梅,等.胆道闭锁53例临床特点与误诊分析[J].实用儿科临床杂志,2010,25(23):1808-1809.