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目的：通过病理学方法，作出肝外胆道闭锁的诊断和预后判定。方法：对２３例婴儿阻塞性胆管病和５例对照的肝组织，按病理诊断和年龄分组，进行肝组织的二维病理学研究和肝内胆管三维构形观察。结果：肝外胆道闭锁与狭窄和新生儿肝炎肝组织的病变相似，仅程度不同。不同年龄组间，胆管增生、汇管区面积和肝纤维化及肝硬化有显著性差异。胆道闭锁的大月龄组中胆道病变和胆栓明显，新生儿肝炎时肝细胞坏死更突出。肝内胆管的三维构形表明，胆道闭锁时增生赫令管多数管腔开放，并互相连接成网络状；少数赫令管形成膨大盲端和局部小叶间胆管形成微囊肿。结论：①阻塞性胆管病时，肝纤维化、胆管增生和汇管区面积与患儿月龄有关；②赫令管形成网络状暗示胆道阻塞，结合胆管的病变和胆栓有助于诊断胆道闭锁；③胆管的微囊肿和赫令管膨大盲端提示胆道闭锁预后差
Objective: To make the diagnosis and prognosis of extrahepatic biliary atresia by pathological method. Methods: Twenty-three cases of obstructive duct disease and 5 cases of control liver tissues were divided into two groups according to pathological diagnosis and age group. Two-dimensional pathological study of liver tissues and three-dimensional configuration of intrahepatic bile duct were performed. Results: Extrahepatic biliary atresia and stenosis and neonatal hepatitis liver lesions similar, only to a different degree. Different age groups, bile duct hyperplasia, portal area and liver fibrosis and cirrhosis were significantly different. Large biliary atresia in the group of biliary tract lesions and gallbladder obvious, newborn hepatitis liver cell necrosis even more prominent. The three-dimensional configuration of the intrahepatic bile duct showed that the most lumen of the hyperplastic hemostasis was open at the biliary atresia and connected with each other into a network; a small number of Healing Holes formed the dilated blind end and the local interlobular bile duct formation microcapsules. Conclusion: ① Obstructive biliary disease, liver fibrosis, bile duct hyperplasia and portal area with the age of children; ② Healing tube network formation of biliary obstruction, combined with bile duct lesions and gallbladder can help diagnose biliary atresia ; ③ microcirculation of the bile duct and Healing tube bulging blind tip prompted poor prognosis of biliary atresia