论文部分内容阅读
目的 评价动态持续十二指肠液检查鉴别诊断婴儿肝炎综合征 (Infantilehepatitissyndrome,IHS)与胆道闭锁 (Biliaryatresia,BA)的价值 ,寻求简单、快速、正确的鉴别诊断方法。方法应用婴儿十二指肠引流管和引流技术进行动态十二指肠液检查 ,观察十二指肠液颜色、定量测定十二指肠液胆红素值、γ 谷氨酰转肽酶 (γ GT)活性和胆汁酸定性或定量测定。结果 5 6 1例婴儿持续性黄疸首次十二指肠液检查 ,在插管后 3～ 8min内获黄色液体 342例 ,持续引流 2 4h获黄色液体 2 1例 ,间接引流 4 8～ 72h获黄色液体 16例。十二指肠液呈淡黄色者 71例 ,十二指肠液呈微黄或白色者 111例 ,经治疗后再次对淡黄色和微黄或白色液体者 182例行十二指肠液检查 ,十二指肠液呈黄色者 91例 ,十二指肠液呈白色者 89例 ,呈微黄者 2例。十二指肠液呈黄色和淡黄色者胆红素定量≥ 8 5 μmol/L ,γ GT >2 0Iu/L ,胆汁酸阳性或定量为 33～ 2 6 0 μmol/L ,十二指肠液无色者胆红素值 0～ 2 μmol/L ,十二指肠液微黄者 2例 ,胆红素分别为 5 .8μmol/L ,胆汁酸阴性 ,γ GT 0～ 5Iu/L。以十二指肠液胆红素≥8 5 μmol/L ,胆汁酸阳性 ,γ GT >2 0Iu/L诊断为IHS 4 70例 ,经随访黄疸完全消退。以十二指肠液 <8 5μmol/L ,胆汁酸阴性 ,γ GT <2
Objective To evaluate the value of dynamic continuous duodenal fluid examination in the differential diagnosis of infantile hepatitis syndrome (IHS) and biliary atresia (BA), and to find a simple, rapid and accurate differential diagnosis method. Methods The duodenal drainage tube and drainage technology were used to detect the dynamic duodenal fluid. The color of duodenal juice was observed. The bilirubin value, γ-GT activity And bile acid qualitative or quantitative determination. Results 56 cases of persistent jaundice in infants with duodenal fluid examination for the first time, 342 cases of yellow liquid within 3 ~ 8min after intubation, continued drainage 24 hours yellow liquid 21 cases, indirect drainage 48 ~ 72h yellow liquid 16 cases. Duodenal fluid was light yellow in 71 cases, duodenal fluid was yellowish or white in 111 cases, after treatment of light yellow and yellowish or white liquid 182 routine duodenal fluid examination, the second finger Intestinal fluid was yellow in 91 cases, 89 cases of duodenal juice was white, was yellow in 2 cases. Duodenal juice yellow and light yellow bilirubin quantitative ≥ 8 5 μmol / L, γ GT> 2 0Iu / L, bile acid positive or quantitative 33 ~ 260 μmol / L, duodenal fluid colorless Bilirubin value of 0 ~ 2 μmol / L, duodenal juice yellow in 2 cases, bilirubin were 5. 8μmol / L, bile acid negative, γ GT 0 ~ 5Iu / L. Duodenal bilirubin ≥8 5 μmol / L, bile acid positive, γ GT> 20Iu / L was diagnosed as IHS 4 70 cases, completely disappeared after follow-up of jaundice. To duodenal fluid <8 5μmol / L, bile acid negative, γ GT <2