CAJ | 학술논문

为了对儿童先天性胆总管囊肿(CBD)导致肝脏病损的有关临床因素及其转归进行分析,对收治的37例先天性胆总管囊肿患儿按肝脏病理改变的程度分成三组:肝硬变组15例,肝硬变前期组20例及正常肝细胞组2例.结果:肝硬变组年龄明显小于肝硬变前期组,前者平均年龄17.37个月,后者为70.25个月(P＜0.001).肝硬变组患儿均有持续性黄疸史,肝硬变前期组有持续性黄疸史的仅3例.肝硬变组囊肿直径平均值为7.8 cm,肝硬变前期组囊肿直径平均值为4.7cm(P＜0.05).肝硬变组9例获术后长期随访,8例恢复满意.结论:①CBD患儿出现症状越早,肝硬变机会越大.②胆道梗阻是CBD导致肝脏病损的主要原因.③CBD Ⅰ型患儿囊肿越大,对胆流动力学影响越大,对肝脏的影响也越大.④对已出现严重肝硬变的CBD患儿仍应持积极态度,胆道梗阻解除后肝硬变仍有逆转的可能.
위료대인동선천성담총관낭종(CBD)도치간장병손적유관림상인소급기전귀진행분석,대수치적37례선천성담총관낭종환인안간장병리개변적정도분성삼조:간경변조15례,간경변전기조20례급정상간세포조2례.결과:간경변조년령명현소우간경변전기조,전자평균년령17.37개월,후자위70.25개월(P＜0.001).간경변조환인균유지속성황달사,간경변전기조유지속성황달사적부3례.간경변조낭종직경평균치위7.8 cm,간경변전기조낭종직경평균치위4.7cm(P＜0.05).간경변조9례획술후장기수방,8례회복만의.결론:①CBD환인출현증상월조,간경변궤회월대.②담도경조시CBD도치간장병손적주요원인.③CBD Ⅰ형환인낭종월대,대담류동역학영향월대,대간장적영향야월대.④대이출현엄중간경변적CBD환인잉응지적겁태도,담도경조해제후간경변잉유역전적가능.
According to the pathological changes of the liver,37 children with congenital biliary dilatation (CBD) were divided into three groups namely:cirrhosis group (15),precirrhosis group (20) and normal liver cells group (2).The average age of the cirrhosis group was 17.37 months and that in the precirrhosis 70.25 months (P＜0.01).All cases of the cirrhosis group and 3 of the precirrhosis group had persistant jaundice.The average diameter of the cyst was 7.8 cm in cirrhosis group but 4.7 cm in precirrhosis group.Eight of the 9 cases with cirrhosis were followed-up with normal liver function.Conclusions:(1) The earlier the symptoms,the worse the cirrhosis;(2) Obstruction of the bile ducts is the main cause of liver cirrhosis;(3) The larger the cyst,the worse the liver features and (4) Active treatment should be given for patients with severe cirrhosis,because it is still reversible.