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目的对内科保守治疗效果差的8例新生儿肝炎综合征患儿进行手术治疗。方法接受手术日龄为45~75d,术中7例确诊为肝外胆道闭锁,行肝门肠吻合术(kasai手术)1例患儿术中确诊为胆汁浓缩综合征,给予胆道冲洗。结果经随访8例患儿短期疗效满意,黄疸消退,血清胆红素明显下降,大便颜色正常,3例曾出现术后胆管炎,经抗炎及抗感染治疗后好转。结论对内科治疗效果不佳、各项检查提示胆道闭锁的患儿早期应进行手术治疗,kasai手术是治疗胆道闭锁的有效术式。长期疗效尚需进一步观察。
Objective To conduct conservative treatment of surgical treatment of 8 cases of neonatal hepatitis syndrome in poor effect of conservative treatment. Methods The operative age ranged from 45 days to 75 days. Seven cases were diagnosed as extrahepatic biliary atresia. One case of hepatico-intestinal anastomosis (kasai operation) was diagnosed as biliary condensation syndrome by intraoperative biliary flushing. Results The follow-up of 8 cases of children with satisfactory short-term efficacy, jaundice, serum bilirubin decreased significantly, stool color was normal, 3 cases had postoperative cholangitis, anti-inflammatory and anti-infection after treatment improved. Conclusion The results of medical treatment are not good. All the tests suggest that the patients with biliary atresia should be treated early, and kasai operation is an effective way to treat biliary atresia. Long-term efficacy still needs further observation.