动态持续十二指肠液检查对婴儿肝炎综合征与先天性肝外胆道闭锁的鉴别诊断价值探讨

Value of duodenal secretion examination in the differential diagnosis between infantile hepatitis syndrome and biliary atresia.

目的 评价动态持续十二指肠液检查对婴儿持续性黄疸的鉴别诊断价值。方法 应用婴儿十二指肠引流管动态持续收集十二指肠液 ,观察颜色、测定总胆红素值和γ 谷氨酰转肽酶 (γ GT)活性。结果 16 8例婴儿持续性黄疸中 133例十二指肠液呈黄色 ,总胆红素值≥ 8 5 μmol/L ,γ GT≥ 2 0IU/L ,经随访黄疸消退 ,诊断为婴儿肝炎综合征 ;35例十二指肠液无色或呈淡黄色 ,总胆红素值 <8 5 μmol/L ,γ GT <2 0IU/L ,经剖腹探查诊断为先天性肝外胆道闭锁。

Objective To investigate the value of persistent duodenal secretion examination in the differential diagnosis between infantile hepatitis syndrome and biliary atresia. Methods The color of the duodenal fluid was observed and bilirubin and γ glutamyl transpeptidase concentration in duodenal fluid were measured.Results 133 children with yellowish duodenal fluid, bilirubin concentration in excess 8 5 μmol/L and γ glutamyl transpeptidase in excess 20IU/L were confirmed to be infantile hepatitis syndrome, while 35 children with colorless duodenal fluid, bilirubin concentration less than 8 5 μmol/L and γ glutamyl transpeptidase less than 20IU/L were diagnosed as biliary atresia by the operation.Conclusion Observation of duodenal fluid color and measurement of bilirubin and γ glutamyl transpeptidase concentration in duodenal fluid is of value to the differential diagnosis between infantile hepatitis syndrome and biliary atresia.