论文部分内容阅读
目的 分析影响胆道闭锁早期诊断和治疗的因素并探讨解决对策。方法 回顾性总结与分析 70例胆道闭锁患儿就诊年龄与临床表现、主诊医生和家长对本病的认识、影像学检查结果等方面对早期诊断的影响 ,探讨延误诊治的各种原因。结果 影像学检查中 ,肝胆核素检查 2 7例 ,6例误诊。B超检查在未掌握观察肝门纤维块前 ,2 3例中仅有 14例诊断正确 ,而在掌握该方法后 ,检查38例 ,35例诊断正确。结论 先天性胆道闭锁延误诊治的原因有 :临床表现不典型、观察病情不细致、主诊医生对本病的认识不足、影像学检查的误诊等。因此建议 :仔细体检 ,医生亲自观察大便颜色 ;B超检查内容包括观察肝门纤维块和胆囊进食前后的变化 ;肝胆核素检查 ,应防止放射物污染 ,减少同位素在体内的分解水化。
Objective To analyze the factors influencing the early diagnosis and treatment of biliary atresia and to explore the solutions. Methods The retrospective analysis and analysis of 70 cases of children with biliary atresia treatment of age and clinical presentation, the attending physicians and parents of the disease awareness, imaging findings and other aspects of the early diagnosis of the impact of delayed diagnosis and treatment of various causes. Results Imaging examination, hepatobiliary radionuclide examination 27 cases, 6 cases misdiagnosed. B-ultrasound in the absence of observation of hepatic fibrosis before, 23 cases of 23 cases were diagnosed correctly, and in the grasp of this method, the examination of 38 cases, 35 cases were diagnosed correctly. Conclusion The causes of delayed diagnosis and treatment of congenital biliary atresia are: atypical clinical manifestations, observation of the disease is not detailed, the attending physician lack of understanding of the disease, imaging misdiagnosis and so on. Therefore, it is recommended that: a careful examination, the doctor personally observe the stool color; B-ultrasound examination includes the observation of liver fibrosis and gallbladder before and after eating changes; liver and radionuclide examination should prevent radioactive contamination and reduce isotope in the body of decomposition hydration.