产前产后一体化诊治在先天性胆管扩张症的应用研究

Application of integrated prenatal and postnatal diagnosis and treatment in congenital biliary dilatation

目的探讨产前产后一体化诊治模式在先天性胆管扩张症的应用效果。方法分析江西省儿童医院2019年1月至2022年4月41例先天性胆管扩张症的临床资料,根据是否应用产前产后一体化诊治模式分为研究组(17例)和对照组(24例),分析研究组及对照组临床症状、肝功能指标、手术并发症、中转开腹、肝脏纤维化情况。结果研究组临床症状发生率较对照组低,差异有统计学意义(P<0.05);研究组肝功能指标丙氨酸转氨酶(ALT)和天门冬氨酸转氨酶(AST)异常比例较对照组低,两组对比差异有统计学意义(P<0.05);研究组手术后并发症发生率较对照组低,差异有统计学意义(P<0.05);研究组中转开腹手术率较对照组高,差异无统计学意义(P>0.05);实验组肝脏发生肝纤维化较对照组少,两组肝纤维化发生率差异无统计学意义(P>0.05)。结论产前产后一体化诊治模式在先天性胆管扩张症的应用,可以做到早干预,改善患儿肝功能,减少手术并发症,值得推广。

Objective To investigate the effect of integrated prenatal and postnatal diagnosis and treatment in congenital biliary dilatation.Methods the clinical data of 41 cases of CBD were analyzed from Children’s hospital of jiangxi province in January 2019 to April 2022,according to whether the application of prenatal diagnosis and treatment of postpartum integration model is divided into research group(17 cases)and control group(24 cases),analysis research group and control group in clinical symptoms,liver function index,liver fibrosis,surgical complications,transfer laparotomy.Results The incidence of clinical symptoms in research group was lower than that in control group,and the difference was statistically significant(P<0.05).The abnormal proportions of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)of liver function indexes in the research group were lower than those in the control group,and the difference was statistically significant(P<0.05).The incidence of postoperative complications in the research group was lower than that in the control group,and the difference was statistically significant(P<0.05).The conversion rate of the research group to open surgery was higher than that of the control group,but there was no statistical significance(P>0.05).The incidence of liver fiber in experimental group was less than that in control group,but there was no statistical significance in the incidence of liver cirrhosis between the two groups(P>0.05).Conclusion The application of integrated prenatal and postnatal diagnosis and treatment in congenital biliary dilatation can achieve early intervention,improve the liver function of children and reduce surgical complications,which is worthy of promotion.