阻塞性新生儿肝炎胆道系统病变及其临床意义

Biliary Tract Lesions in Obstructive Neonatal Hepatitis and Its Clinical Significance

目的分析阻塞性新生儿肝炎胆道系统病变及其临床意义。方法回顾性分析2012年1月至2018年9月扬州大学附属淮安市妇幼保健院收治的27例阻塞性新生儿肝炎患儿,均接受肝组织活检,对比胆道造影冲洗前后肝外胆管形态。结果27例患儿血胆红素水平87~231μmol/L。小便颜色深黄色,粪便逐渐变成淡黄色。肝脏出现不同程度变大,质地较硬,2例肝脏表面呈结节性硬化。其中4例乙肝表面抗原阳性。所有患儿均出现胆囊壁增厚情况。对27例患儿跟踪随访10个月~7年,其中存活24例,3例死亡,均死于肝功能衰竭。结论针对阻塞性新生儿肝炎患儿行腹腔镜胆道造影冲洗手术治疗可有效改善患儿预后。

Objective To analyze the biliary tract lesions of obstructive neonatal hepatitis and its clinical significance.Methods Twenty-seven cases of obstructive neonatal hepatitis from January 2012 to September 2018 were selected and all received liver biopsy.The morphology of extrahepatic bile duct was compared before and after washing with cholangiography.Results The serum bilirubin level of 27 children was 87~231μmol/L.Urine color was dark yellow,feces gradually became pale yellow.The liver appeared large and hard in varying degrees,with nodular sclerosis on the surface of the liver in 2 cases.Hepatitis B surface antigen was positive in 4 of them.Gallbladder wall was thickening in all children.Twenty-seven cases were followed up for 10 months to 7 years.Among them,24 cases survived,3 cases died of liver failure.Conclusion Laparoscopic cholangiography rinse can effectively improve the prognosis of children with obstructive neonatal hepatitis.