胆道无扩张的新生儿和婴儿梗阻性黄疸的治疗

Treatment of Obstructive Jaundice without Cholanglectasis In the Newborn and Infant

研究56例无胆道扩张的新生儿及婴儿梗阻性黄疸的临床特点及外科手术时机及效果。超声证实无肝内外胆道扩张的新生儿及婴儿梗阻性黄疸,均行手术探查及病理学检查。手术证实56例梗阻性黄疸中有30例为胆汁粘稠症,并经胆道冲洗治愈;26例为胆道闭锁,预后不良。二者在肝内小胆管增生这一病理改变上存在一致性,可能是对胆道梗阻的代偿机制之一。对于超声提示无肝内外胆道扩张的新生儿及婴儿梗阻性黄疸,经1～2周的抗炎、保肝、利胆治疗无效后,应及时手术探查,以使胆汁粘稠症的患儿得到有效治疗。

To study 56 cases children with obstructive jaundice without cholangiectasis and to investigate the clinical characteristic and the operating time and effects. Sonogrophy, operative exploration and pathological examination were performed in all patients. We identified 30 cases of mucoid bile syndrome (MBS) and 26 cases of biliary atresia (BA) through exploration. The newborn and infants with MBS were performed bile duct rinsing and got well. There are common pathologic changes between MBS and BA that is hyperplasia of small intrahepatic ducts. The treatment effect is different because of the different obstructive cauese between MBS and BA. So, for those patients of neonatal hepatitis who had jaundice, a-cholic stools and dark urine, we should make operation on the children even though no cholangiectasis if there are no effect after therapy with antiinformation and liver protective medicine for 1 - 2 weeks.