早期胆管炎对Kasai＇s术远期疗效的影响  

Effects of early cholangitis after Kasai procedure on the long-term outcome in biliary atresia

作　　者：刘钧澄[1] 徐哲[1] 李桂生[1] 佘锦标[1] 张志崇[1] 何广芬[1] 潘翠玲[1] 

机构地区：[1]中山大学附属第一医院小儿外科,广州510080

出　　处：《中华小儿外科杂志》2008年第11期675-677,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨Kasai＇s术后胆管炎对胆道闭锁（BA）长期生存的影响。方法通过对92例BA行Kasai＇s术时的手术年龄、术式和术后胆管炎发生等临床资料进行收集和分析，特别是重点分析早期胆管炎对患儿的影响。结果对1989年3月至1997年3月共92例BA行Kasai＇s术，手术年龄30～137d。其中男55例，女37例。失访3例，死亡66例，存活23例中男14例，女9例，存活患儿年龄最大者现已满19岁。92例中，在出生后60d内手术25例，现存活5例；6190d手术53例，现存活15例。91d以上手术14例，现存活3例。本组发生早期胆管炎58例，现仍存活7例。19例因肝门部胆管梗阻再次手术，现存活4例。结论①胆管炎的处理是BA治疗过程中最困难的一环。胆管炎是BA术后最常见又是最难处理的并发症；②防止早期胆管炎的发生是手术成功的关键，早期胆管炎的危害大。在适宜的年龄进行Kasai＇s术时，有无胆管炎发生与生存率关系更密切；③对因胆管炎引起的肝门部胆管梗阻应积极治疗；④早期胆管炎不但影响手术后的生存率，还对远期生活质量有影响。Objective To evaluate the effects of cholangitis after hepatic portoenterostomy for biliary atresia on the long term survival Methods 92 patients with biliary atresia admitted into the First Affiliated Hospital of Sun Yat - Sen University in-patients between March 1989 to March 1997 underwent Kasai procedure were reviewed. The clinical data including the age, operation methods and the post-operative cholangitis, were analyzed. Results The patients＇ age ranged from 30 days to 137 days. There were 55 boys and 37 girls. The oldest patient was 19 years old. Currently, 14 boys and 9 girls are still alive. This includes 5 out of 25 patients younger than 60 days, 15 out of 53 patients be- tween 61 days and 90 days, 3 out of 14 patients older than 91 days at the time of operation respectively. Seven out of 58 patients with early cholangitis are still alive. Four out of 19 patients survived after re-operation. Conclusions Cholangitis affects long term survival. Active treatment is required for bile duct obstruction secondary to cholangits.

关 键 词：胆道闭锁 胆管炎 预后 

分 类 号：R686[医药卫生—骨科学]