摘要
目的了解新生儿肝外胆道囊性病变的不同类型及其临床特点,掌握其鉴别诊断的要点。方法分析9例新生儿肝外胆道囊性病变患儿的临床表现、肝功能、B超、CT、光镜、术中胆道造影的资料。结果本组胆道闭锁和新生儿胆总管囊肿女性多见,以梗阻性黄疸为主要表现,肝功能检查结果提示梗阻性黄疸。二者肝脏的组织学改变相似。但B超和CT检查发现,胆道闭锁组囊肿与胆囊大小均小于胆总管囊肿组。术中胆道造影显示,Ⅰ型胆道闭锁组肝内胆管变形、连续性中断;Ⅲ型胆道闭锁肝内胆管无法显示;胆总管囊肿组肝内胆管形态正常或略有被动扩张。结论多种胆道畸形都可以表现为新生儿肝外胆道囊肿,B超和术中胆道造影可以帮助鉴别这类疾病并且为治疗提供帮助。
Objective To study the clinical characteristics and differential diagnosis of extrahepatic biliary cystic lesions（EBCL） in neonates. Methods The data of 9 neonates with EBCL, 4 biliary atria （BA group）, 5 choledochal cys （CC group）was retrospectively analyzed. Results Both malformations were more common in girls. They presentecl obstructive jaundice. There were no significant difference in hepatic biochemistry and histologic examination between the two groups. But the length and size of the cysts and gallbladders in the BA group were shorter than those in the CC group found by B ultrasound and CT. Intraoperative cholangiography showed that deformation and destruction of intrahepatic biliary tree were demonstrated in a type Ⅰ BA; intrahepatic biliary tree could not be visualized in a type Ⅲ BA; the morphology of intrahepatic biliary tree was normal in the CC group. Conclusions Biliary malformations may manifest as extrahepatic biliary cysts in neonates. B ultrasound and intraoperative cholangiography can provide reliable information for diagnosis and surgical treatment of the lesions.
出处
《中国新生儿科杂志》
CAS
2006年第2期70-73,共4页
Chinese Journal of Neonatology
