胆道闭锁Kasai术后胆管炎的发病机制探讨

The study on pathogenesis of cholangitis after Kasai procedure in children with biliary atresia

胆管炎是胆道闭锁Kasai术后的常见并发症,对患儿的生活质量及自肝生存均有较大影响。术中患儿自身肝脏状况会影响术后胆汁引流,Kasai术后胆管炎的发生与胆汁引流状况关系密切。空肠胆支内存在的细菌因肠道环境改变而大量繁殖可能是胆管炎发生的主要原因,远端空肠内容物反流入空肠胆支中也可诱发胆管炎。除了直接逆行感染外,肠道细菌突破肠黏膜经门静脉入肝,也是导致胆管炎发生的原因之一。

Cholangitis is among the most common complication after Kasai procedure in children with biliary atresia,which has great impact on the quality of life and native liver survival of children.The liver condition during Kasai operation can affect the postoperative bile drainage.The incidence of cholangitis after Kasai operation is associated with bile drainage.The proliferation of bacteria within the bile conduit of jejunum due to the change of intestinal environment maybe the main cause of cholangitis.Intestinal content reflux after Kasai operation may also induce the occurrence of cholangitis.In addition to the direct retrograde infection,enteric bacteria can also break through the intestinal mucosa and enter the liver through the portal vein to induce cholangitis.