中国医疗设备
中國醫療設備
중국의료설비
CHINA MEDICAL EQUIPMENT
2013年
10期
153-155,111
,共4页
贺晓%高剑波%滑少华%于瑞娜%张瑞芳
賀曉%高劍波%滑少華%于瑞娜%張瑞芳
하효%고검파%활소화%우서나%장서방
超声诊断仪%高频超声探头%左右肝管%肝外胆管%胆囊%胆道闭锁%婴儿肝炎综合征
超聲診斷儀%高頻超聲探頭%左右肝管%肝外膽管%膽囊%膽道閉鎖%嬰兒肝炎綜閤徵
초성진단의%고빈초성탐두%좌우간관%간외담관%담낭%담도폐쇄%영인간염종합정
ultrasound Diagnostic Equipment%high frequency ultrasound probe%left&right hepatic duct%extrahepatic biliary duct%gallbladder%biliary atresia%infantile hepatitis syndrome
目的：探讨高频超声探查左右肝管、肝外胆管及胆囊在胆道闭锁（Biliary Atresia, BA）和婴儿肝炎综合征（Infantile Hepatitis Syndrome，IHS）鉴别诊断中的价值。方法使用高频超声对58例持续性阻塞性黄疸患儿进行超声检查，前瞻性地观察左右肝管、肝外胆管上段情况，胆囊大小形态、哺乳后变化（观察至哺乳后2.5 h或至收缩率＞50%）及肝门部有无三角形纤维斑块和囊性回声，并与临床诊断或手术结果进行对照。结果BA 28例：26例左、右肝管及肝外胆管未探及，胆囊表现为4种情况；2例左、右肝管及肝外胆管呈缝隙状，壁毛糙，内透声差；肝门部纤维斑块22例，4例肝门部无纤维斑块的患儿年龄均＜3个月；肝门部囊性回声7例。IHS 30例，左、右肝管及肝外胆管均可探及。误诊为胆道闭锁3例，左、右肝管及肝外胆管均呈缝隙状，壁毛糙，内透声差；27例胆囊表现为3种情况；肝门部囊性回声3例。BA与IHS在左、右肝管和肝外胆管是否可见方面差异有统计学意义（P=0.00）。左、右肝管和肝外胆管未探及与肝门部纤维斑块在BA的诊断方面差异有统计学意义（P=0.01），其中年龄＜3个月的患儿差异有统计学意义（P=0.01），年龄＞3个月的患儿差异无统计学意义（P=1.00）。结论高频探头能够清晰显示婴儿左、右肝管及肝外胆管情况，对早期BA与IHS的鉴别诊断有较高的价值；患儿胆囊收缩率检查建议观察至哺乳后2.5 h。
目的：探討高頻超聲探查左右肝管、肝外膽管及膽囊在膽道閉鎖（Biliary Atresia, BA）和嬰兒肝炎綜閤徵（Infantile Hepatitis Syndrome，IHS）鑒彆診斷中的價值。方法使用高頻超聲對58例持續性阻塞性黃疸患兒進行超聲檢查，前瞻性地觀察左右肝管、肝外膽管上段情況，膽囊大小形態、哺乳後變化（觀察至哺乳後2.5 h或至收縮率＞50%）及肝門部有無三角形纖維斑塊和囊性迴聲，併與臨床診斷或手術結果進行對照。結果BA 28例：26例左、右肝管及肝外膽管未探及，膽囊錶現為4種情況；2例左、右肝管及肝外膽管呈縫隙狀，壁毛糙，內透聲差；肝門部纖維斑塊22例，4例肝門部無纖維斑塊的患兒年齡均＜3箇月；肝門部囊性迴聲7例。IHS 30例，左、右肝管及肝外膽管均可探及。誤診為膽道閉鎖3例，左、右肝管及肝外膽管均呈縫隙狀，壁毛糙，內透聲差；27例膽囊錶現為3種情況；肝門部囊性迴聲3例。BA與IHS在左、右肝管和肝外膽管是否可見方麵差異有統計學意義（P=0.00）。左、右肝管和肝外膽管未探及與肝門部纖維斑塊在BA的診斷方麵差異有統計學意義（P=0.01），其中年齡＜3箇月的患兒差異有統計學意義（P=0.01），年齡＞3箇月的患兒差異無統計學意義（P=1.00）。結論高頻探頭能夠清晰顯示嬰兒左、右肝管及肝外膽管情況，對早期BA與IHS的鑒彆診斷有較高的價值；患兒膽囊收縮率檢查建議觀察至哺乳後2.5 h。
목적：탐토고빈초성탐사좌우간관、간외담관급담낭재담도폐쇄（Biliary Atresia, BA）화영인간염종합정（Infantile Hepatitis Syndrome，IHS）감별진단중적개치。방법사용고빈초성대58례지속성조새성황달환인진행초성검사，전첨성지관찰좌우간관、간외담관상단정황，담낭대소형태、포유후변화（관찰지포유후2.5 h혹지수축솔＞50%）급간문부유무삼각형섬유반괴화낭성회성，병여림상진단혹수술결과진행대조。결과BA 28례：26례좌、우간관급간외담관미탐급，담낭표현위4충정황；2례좌、우간관급간외담관정봉극상，벽모조，내투성차；간문부섬유반괴22례，4례간문부무섬유반괴적환인년령균＜3개월；간문부낭성회성7례。IHS 30례，좌、우간관급간외담관균가탐급。오진위담도폐쇄3례，좌、우간관급간외담관균정봉극상，벽모조，내투성차；27례담낭표현위3충정황；간문부낭성회성3례。BA여IHS재좌、우간관화간외담관시부가견방면차이유통계학의의（P=0.00）。좌、우간관화간외담관미탐급여간문부섬유반괴재BA적진단방면차이유통계학의의（P=0.01），기중년령＜3개월적환인차이유통계학의의（P=0.01），년령＞3개월적환인차이무통계학의의（P=1.00）。결론고빈탐두능구청석현시영인좌、우간관급간외담관정황，대조기BA여IHS적감별진단유교고적개치；환인담낭수축솔검사건의관찰지포유후2.5 h。
Objective To investigate the effects of the left and right hepatic duct, extrahepatic biliary duct and gallbladder high frequency ultrasound imaging in diagnosis of BA (Biliary Atresia) and IHS (Infantile Hepatitis Syndrome). Methods Through examinations of 58 obstructive jaundice infants by high frequency ultrasonography, prospective observations of the ultrasonograms obtained were made on the left and right hepatic duct, the upper extrahepatic biliary duct, the size, morphology and post-breastfeeding changes (until 2.5 h after breast-feeding or the contraction rate>50%) of gallbladder as well as triangular fibrotic mass and cyst echoes in hepatic hilum. The clinical diagnosis or operation results were taken as the reference so as to make comparisons with the examination results. Results There were 28 cases of BA and 30 IHS. Among 28 patients with BA, the gallbladder of 26 patients were revealed in 4 different conditions without display of the left and right hepatic duct and extrahepatic biliary duct;the crevice-like left and right hepatic duct and extrahepatic biliary duct were found in 2 cases with rough wall and low echo;there were 22 patients with triangular ifbrotic masses in hepatic hilum and 4 (the average age<3 months) without triangular ifbrotic masses;7 patients were revealed with cyst echo in the hepatic hilum. As for 30 IHS patients, their left and right hepatic ducts and extrahepatic biliary duct were all well displayed:3 patients were misdiagnosed as BA with the features of the crevice-like left and right hepatic ducts and extrahepatic biliary duct, rough wall and low echo;the gallbladder of 27 patients were revealed in 4 different conditions;cyst echo was found in the hepatic hilum in 3 patients. The differences between BA and IHS were of statistical signiifcance (P=0.00) in visualization of the left and right hepatic ducts and the extrahepatic biliary duct. Statistically signiifcant differences (P=0.01) existed between the unrevealed left & right hepatic duct, extrahepatic biliary duct and the triangular ifbrotic mass found in the hepatic in the diagnosis of BA, among which there were statistically signiifcant differences (P=0.01) in patients (age<3 months) and no statistical signiifcance (P=1.00) in patients (age>3 months). Conclusion With clear display of the left&right hepatic ducts and the extrahepatic biliary duct, the high frequency ultrasound is effective in the early diagnosis of BA and IHS. It is recommended to observe the infants until 2.5 h after breast-feeding so as to obtain the gallbladder contraction rate.
