| 张丽莎,张 丹,万小梅,王佳蕊,张玲懋.彩色多普勒超声对新生儿肝炎综合征和胆道闭锁的临床鉴别价值[J].,2017,17(29):5748-5752 |
| 彩色多普勒超声对新生儿肝炎综合征和胆道闭锁的临床鉴别价值 |
| Value of Color Doppler Ultrasound in Clinical Identification of Infant Hepatitis Syndrome and Biliary Atresia |
| 投稿时间：2017-05-16 修订日期：2017-06-12 |
| DOI：10.13241/j.cnki.pmb.2017.29.035 |
| 中文关键词: 彩色多普勒超声 肝炎综合征 胆道闭锁 诊断 鉴别 |
| 英文关键词: Color doppler ultrasound Hepatitis syndrome Biliary atresia Diagnosis Identification |
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| 中文摘要: |
| 摘要 目的：探讨彩色多普勒超声对新生儿肝炎综合征（HS）和胆道闭锁（BA）的临床鉴别诊断价值。方法：收集2014年3月-2017年3月我院收治的53例HS患儿（淤胆型HS 32例，黄疸型HS 21例）和39例BA患儿，并于同期随机选取50例非黄疸性疾病婴儿作为对照组。所有研究对象均行彩色多普勒超声检查，分别比较不同患儿的超声检查结果，包括肝脾的大小、形态、内部回声、左右肝管及肝外胆管的可探性以及血流动力学变化等指标。结果：淤胆型HS组、黄疸型HS组患儿的空腹胆囊形态正常率高于BA组，但三组患儿均低于对照组（均P<0.05）；淤胆型HS组、黄疸型HS组患儿胆囊收缩率＞50%时间小于BA组，且三组均大于对照组（均P<0.05）；淤胆型HS组、黄疸型HS组及对照组左右肝管及肝外胆管的显示率高于BA组（P<0.01）；淤胆型HS组、黄疸型HS组及对照组患儿肝门部囊性回声率及纤维斑块率均低于BA组患儿（P<0.05）。BA组患儿的门静脉的平均流速（VPV）均低于其他三组，而PV淤血指数(CIPV)、肝动脉的前后径（DHA）、HA的阻力指数（RIHA）、HA/PV流速的比率（A/P）、脾动脉的RI（RISPA）水平均高于其他三组（均P<0.05）。结论：彩色多普勒超声可通过检查患者组织病理改变及血流动力学指标（VPV、CIPV、DHA、RIHA、A/P、RISPA）鉴别诊断HS和BA。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the clinical identification value of color doppler ultrasound in infant hepatitis syndrome (HS) and biliary atresia (BA). Methods: A total of 53 infants with HS (including 32 infants with cholestatic type HS, and 21 infants with icteric type HS) and 39 infants with BA, who were treated in Zigong Maternal and Child Health-Care Hospital of Sichuan Province from March 2014 to March 2017, were selected, and at the same time, 50 infants without jaundice disease were randomly chosen as control group. All the subjects were examined by color doppler ultrasound. Then the results(including liver and spleen size, shape, internal echo, detectable property of left and right hepatic duct and extrahepatic bile duct and changes of hemodynamic indexes) were compared among the chil- dren patients. Results: The normal shape rates of fasting gallbladder in cholestatic type HS group and icteric type HS group were higher than those in BA group, but the three groups were all lower than control group(all P<0.05). The average time of gallbladder contraction rate＞50% in cholestatic type HS group and icteric type HS group was shorter than that in the BA group, but the three groups were all longer than control group(all P<0.05). The detectable property rates of left and right hepatic duct and extrahepatic bile duct in cholestatic type HS group, icteric type HS group and control group were higher than those in BA group(P<0.01). The cystic echo and fibrous plaque rates of hepatic portal in cholestatic type HS group,icteric type HS group and control group were lower than those in BA group(P<0.05).The mean flow velocity of portal vein(VPV) level in BA group was lower than that in the other three groups,while its congestion index of PV(CIPV), anteroposterior diameter of hepatic artery(DHA), resistance index of HA(RIHA), flow velocity radio of HA/PV(A/P), and the RI of splenic artery (RISPA) were higher than those in the other three groups(all P<0.05). Conclusion: The changes of tissue pathology and hemodynamic indexes(VPV, CIPV, DHA, RIHA, A/P, RISPA) can be examined by color doppler ultrasound to identify infant HS and BA. |
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