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目的通过应用甲泼尼龙琥珀酸钠对胆道闭锁(biliary atresia,BA)与胆汁粘稠综合征(inspissated bile syndrome,IBS)进行诊断性治疗,探讨该方法在诊断和治疗梗阻性黄疸(obstructive jaundice)中的临床价值。方法收集2010年1月至2014年12月间作者收治的新生儿及婴幼儿梗阻性黄疸病例106例作为研究对象,均予甲泼尼龙琥珀酸钠诊断性治疗。其中BA 74例,IBS 32例。临床观察指标包括大便颜色、血生化检查与B超。应用SPSS 17.0统计学软件进行统计分析。结果经甲泼尼龙琥珀酸钠治疗3 d、5 d后,IBS组血TB,DB,TBA降低较BA组显著,差异有统计学意义(P<0.05);IBS组血AST、ALT、γ-GT降低较BA组明显,差异元统计学意义(P>0.05),血胆红素水平(TB、DB)以及肝功能(TBA)可以反应激素治疗后病情变化。结论应用甲泼尼龙琥珀酸钠治疗梗阻性黄疸可以作为鉴别BA和IBS的初步诊断方法。该方法简单、无创,可以在临床上广泛应用。
Objective To evaluate the diagnostic value of methylprednisolone sodium succinate in the diagnosis and treatment of obstructive jaundice by biliary atresia (BA) and inspissated bile syndrome (IBS) In the clinical value. Methods A total of 106 cases of obstructive jaundice in infants and infants admitted to our hospital from January 2010 to December 2014 were enrolled in the study. All of them were given methylprednisolone sodium succinate for diagnosis. Among them, 74 cases were BA and 32 cases were IBS. Clinical observations include stool color, biochemical tests and B-ultrasound. Apply SPSS 17.0 statistical software for statistical analysis. Results The blood TB, DB and TBA in IBS group were significantly lower than those in BA group after treated with methylprednisolone sodium succinate for 3 days and 5 days (P <0.05). The levels of AST, ALT, γ- (P> 0.05). Serum bilirubin level (TB, DB) and liver function (TBA) could reflect the change of the disease after hormone therapy. Conclusion The application of methylprednisolone sodium succinate in the treatment of obstructive jaundice can be used as a preliminary diagnostic method for the differential diagnosis of BA and IBS. The method is simple, non-invasive, can be widely used in clinical practice.