摘要
目的评估胆道闭锁患儿Kasai术后远期预后。方法1968年～1983年,法国巴黎Bicêtre医院儿外科共对271例胆道闭锁患儿行Kasai手术或其变异术式,术后随访20年,对带自体肝生存患者进行综合性评估。结果271例患者中,63例(占23%)带自体肝者至少生存20年。肝功能结果显示:21例总胆红素指标正常,其中12例γ-GT和转氨酶指标正常;44例有门脉高压表现;19例仍有晚期胆道感染发作;6例并发胆道结石;61例患者肝穿刺活检提示有不同程度肝硬化表现。20岁之后,2例死于肝功能衰竭;10例已行肝移植;4例正等待肝移植。结论胆道闭锁患儿Kasai术后带自体肝20年生存率仅为23%,大部分患儿转肝移植治疗。即使带自体肝生存患儿随访各项指标也不令人满意。因此密切关注肝脏情况,尽早发现并发症,对决定进一步治疗措施,改善预后,具有积极的意义。
Objective To define the long-term prognosis of children undergoing the Kasai operation for biliary atresia. Methods A retrospective study was carried out in 271 patients operated on between 1968 and 1983 in Bicgtre hospital. Results Twenty years after opreration, 63 （23%） were alive with their native liver. Serum bilirubin was normal in 21 of＇ these patients; 12 also had normal serum transaminase and gammaglutamyltransferase activities; 44 had signs of portal hypertension, 19 had advanced stage bacterial cholangitis and 6 gallstones,66 showed the different degree of liver cirrhosis by liver puncture biopsy. After age 20, 2 patients died of liver failure and 10 underwent liver grafting; 4 cases vival with native liver was significantly better axe awaiting liver transplantation.Twenty-year surin children with biIiary atresia restrictedto the hepatic ducts or with cysts at the porta hepatis. Conclusion In the long-term, less than 23% of infants with biliary atresia treated by Kasai operation may avoid liver transplantation, even those with native liver their various markers also not a satisfactory recovery. Therefore, closely concern for change of hepatic function, as much as possible early detected out complication,which have active significance for improvement of prognose and therapeutic outcome.
出处
《临床小儿外科杂志》
CAS
2005年第6期401-405,共5页
Journal of Clinical Pediatric Surgery
