超声在新生儿梗阻性黄疸诊疗中的应用价值分析

Application Value of Ultrasound in Diagnosis and Treatment of Neonatal Obstructive Jaundice

本研究探讨超声在新生儿梗阻性黄疸诊疗中的应用价值。选取梗阻性黄疸新生儿82例,其中胆道闭锁39例,肝炎综合征43例。胆道闭锁患儿胆囊长径明显小于肝炎综合征患儿(P<0.05),而肝右动脉内径、肝右动脉/门静脉内径值、TC征明显高于肝炎综合征患儿(P<0.05);胆道闭锁患儿门静脉流速明显低于肝炎综合征患儿(P<0.05),而门静脉淤血指数、肝动脉阻力指数明显高于肝炎综合征患儿(P<0.05);胆囊长径、肝右动脉内径、肝右动脉/门静脉内径值、TC征、门静脉流速、门静脉淤血指数和肝动脉阻力指数建立Logistic方程,其诊断胆道闭锁的灵敏性和特异性为94.87%和93.02%。超声在新生儿梗阻性黄疸诊断中有较好的应用价值,可为胆道闭锁和肝炎综合征鉴别诊断提供帮助。

This study discusses the application value of ultrasound in the diagnosis and treatment of neonatal obstructive jaundice.Eighty-two neonates with obstructive jaundice were selected.There were 39 cases of biliary atresia and 43 cases of hepatitis syndrome.The diameter of gallbladder in children with biliary atresia was significantly smaller than that in children with hepatitis syndrome(P<0.05),while the diameter of right hepatic artery,the diameter ratio of right hepatic artery to portal vein and TC syndrome were significantly higher than those in children with hepatitis syndrome(P<0.05).The flow velocity of portal vein in children with biliary atresia was significantly lower than that in children with hepatitis syndrome(P<0.05),while the portal vein congestion index and hepatic artery resistance index were significantly higher than those in children with hepatitis syndrome(P<0.05).Logistic regression analysis was established for gallbladder length,right hepatic artery diameter,right hepatic artery/portal vein diameter ratio,TC sign,portal vein velocity,portal vein congestion index and hepatic artery resistance index,the sensitivity and specificity of diagnosis of biliary atresia were 94.87%and 93.02%.Ultrasound has good application value in the diagnosis of neonatal obstructive jaundice and can provide help for differential diagnosis of biliary atresia and hepatitis syndrome.