论文部分内容阅读
为了对儿童先天胆总管囊肿（ＣＢＤ）导致肝脏病损的有关临床因素及其转归进行分析， 对收治的３７例先天性胆总管囊肿患儿按肝脏病理改变的程度分成三组：肝硬变组１５例，肝硬变前期组２０例及正常肝细胞组２例。结果，肝硬变组年龄明显小于肝硬变前期组，前者平均年龄１７．３７个月，后者为７０．２５个月（Ｐ＜０．００１）。肝硬变组患儿均有持续性贡疽史，肝硬变前期组有持续性黄疸史的仅３例，肝硬变组囊肿直径平均值为７．８ｃｍ，肝硬变前期组囊肿直径平均值为４．７ｃｍ（Ｐ＜０．０５）。肝硬变组９例获术后长期随访，８例恢复满意。结论：①ＣＢＤ患儿出现症状越早，肝硬变机会越大。 ②胆道梗阻是ＣＢＤ导致肝脏病损的主要原因。 ③ＣＢＤＩ型患儿囊肿越大，对胆流动力学影响越大， 对肝脏的影响也越大。 ④对已出现严重肝硬变的ＣＢＤ患儿仍应持积极态度，胆道梗阻解除后肝硬变仍有逆转的可能。
In order to analyze the clinical factors and prognosis of liver lesions caused by congenital choledochal cyst (CBD) in children, 37 children with congenital choledochal cyst were divided into three groups according to the degree of hepatic pathological changes: cirrhosis 15 cases, 20 cases of pre-cirrhosis group and 2 cases of normal liver cell group. The results showed that the age of cirrhosis group was significantly less than the pre-cirrhosis group, the former average age of 17.37 months, while the latter was 70.25 months (P <0.001). Liver cirrhosis patients had persistent history of gangrene, pre-cirrhosis group had a history of persistent jaundice in only 3 cases, cirrhosis group average cyst diameter was 7.8cm, pre-cirrhosis group cyst diameter average The value was 4.7 cm (P <0.05). Nine patients with cirrhosis were followed up for a long time and 8 patients recovered satisfactorily. Conclusion: (1) The earlier the symptoms in children with CBD, the greater the chance of cirrhosis. ② biliary obstruction is the main cause of hepatic lesions caused by CBD. ③ CBDI-type cysts in children with larger, the greater the impact on bile flow dynamics, the greater the impact on the liver. ④ have serious positive cirrhosis of the CBD in children with a positive attitude, biliary obstruction after the lifting of liver cirrhosis may still be reversed.