摘要
目的:分析胆道闭锁诊疗及预后情况,探讨胆道闭锁Kasai手术的意义。方法:回顾性分析郑州大学第一附属医院小儿外科2008年8月至2013年4月收治的99例胆道闭锁患儿的病例资料,定期门诊复查并电话随访,分析所有患儿的手术及存活情况。结果:20例未行Kasai手术患儿中,3例存活,均有肝硬化、腹水等症状;77例行Kasai手术的患儿中,46例存活,两组差异有统计学意义(P<0.05)。2例行胆囊十二指肠吻合术,均存活。行Kasai手术的存活患儿中,手术日龄在90 d以内(包含90 d)的患儿30例存活,手术日龄>90 d患儿16例存活,差异有统计学意义(P<0.05)。结论:根据临床表现、影像学检查、腹腔镜探查并活检等有助于胆道闭锁的诊断。早诊断、早治疗,及时行Kasai术可以延长胆道闭锁患儿的生命,为肝移植赢得时间。
Objective： To investigate the diagnosis,treatment and prognosis of biliary atresia, and discuss the meaning of Kasai＇ s surgery. Methods ： Retrospectively analyze clinical data of 99 pa- tients with BA who were chosen from The First Affiliated Hospital of Zhengzhou University in recent five years. Patients were followed up by review or phone calls. The operative procedures and sur- vival rates of all the patients were analyzed. Results ： 20 cases gave up after laparoscopic explora- tion,3 cases survived. The survivors all had symptoms such as cirrhosis and ascites. 46 cases sur- vived in 77 patients who underwent Kasai surgery. The difference was statistically significant （P 〈 0.05）. 2 cases survived who underwent cholecystoduodenostomy. During the children who sur- vived after Kasai surgery,surgical age was under 90 days in 30 cases and above 90 days in 16 ca- ses. The difference was statistically significant （P 〈 O. 05）. Conclusion ： The clinical manifesta- tions, radiological examinations, laparoscopic exploration and biopsy are helpful to early diagnosis of biliary atresia;Kasai procedure is still the first choice for BA, which could save precious time for liver transplantation.
出处
《河南医学研究》
CAS
2013年第6期825-828,共4页
Henan Medical Research
