新生儿肝炎综合征外科治疗的分析

Clinical Study of Surgical Therapy in Neonatal Hepatitis Syndrome

目的对内科保守治疗效果差的8例新生儿肝炎综合征患儿进行手术治疗。方法接受手术日龄为45~75d,术中7例确诊为肝外胆道闭锁,行肝门肠吻合术（kasai手术）1例患儿术中确诊为胆汁浓缩综合征,给予胆道冲洗。结果经随访8例患儿短期疗效满意,黄疸消退,血清胆红素明显下降,大便颜色正常,3例曾出现术后胆管炎,经抗炎及抗感染治疗后好转。结论对内科治疗效果不佳、各项检查提示胆道闭锁的患儿早期应进行手术治疗,kasai手术是治疗胆道闭锁的有效术式。长期疗效尚需进一步观察。

Objective Eight patients with neonatal hepatitis syndrome,received limited outcome of internal medicine therapy,were done operation.Methods Underwent surgical operation on 45~75 days old.7 cases who were diagnosed with biliary atresia in the operation underwent portoenterostomy Kasai procedure,and 1 patient with inspissated bile syndrome received biliary tract washing.Results All patients obtained satisfied short-term outcome： jaundice recession,obvious serumbilirubin descent and normal stool color.Cholangitis appeared in 3 cases postoperatively and relieved gradually after anti-infection and anti-inflammation treatment.Conclusion It is commented that the early surgical treatment is necessary in neonatal hepatitis syndrome patients with uneffective internal medicine treatment and portoenterostomy Kasai procedure is an effective surgical method.The long-term outcome of surgical therapy needs further survey.