高频超声对胆道闭锁性黄疸及非胆道闭锁性黄疸的鉴别诊断

发布时间：2018-12-17 00:36

【摘要】：目的比较胆道闭锁性黄疸及非胆道闭锁性黄疸患儿的胆囊形态结构特点,高频超声评估胆囊形态结构对黄疸患儿的诊断价值。方法回顾性分析河北医科大学第二医院小儿外科2009—2013年收治的22例胆道闭锁性黄疸患儿(胆道闭锁组)及25例非胆道闭锁性黄疸患儿(非胆道闭锁组)胆囊形态结构的高频超声图像,并比较两组类似胆囊结构/胆囊的长径、前后径。分别应用方法 1(以类似胆囊结构/胆囊的长径25 mm为临界点)及方法 2(以类似胆囊结构/胆囊的前后径6 mm为临界点)对胆道闭锁性黄疸和非胆道闭锁性黄疸进行鉴别。结果胆道闭锁组和非胆道闭锁组患儿就诊日龄比较,差异无统计学意义(P0.05);胆道闭锁组较非胆道闭锁组类似胆囊结构/胆囊的长径〔(16±8)mm与(29±7mm)〕缩短,类似胆囊结构/胆囊的前后径〔(4±2)mm与(6±3)mm〕缩短(P0.05)。方法 1对胆道闭锁性黄疸的检出率为82%(18/22),对非胆道闭锁性黄疸的检出率为88%(22/25);方法2对胆道闭锁性黄疸的检出率为91%(20/22),对非胆道闭锁性黄疸的检出率为56%(14/25);两种方法对胆道闭锁性黄疸的检出率比较,差异无统计学意义(χ2=0.77,P=0.380);方法 1对非胆道闭锁性黄疸的检出率高于方法 2(χ2=6.35,P=0.012)。结论胆道闭锁性黄疸患儿类似胆囊结构/胆囊的长径、前后径均小于非胆道闭锁性黄疸患儿。高频超声可以清晰地显示胆囊的形态结构,在区分类似胆囊结构和正常胆囊结构当中有较好的临床价值。以类似胆囊结构/胆囊的长径25 mm为临界点能更好地鉴别胆道闭锁性黄疸和非胆道闭锁性黄疸。
[Abstract]:Objective to compare the characteristics of gallbladder morphology in children with biliary atresia jaundice and non-biliary atresia jaundice, and to evaluate the diagnostic value of high frequency ultrasound in the diagnosis of children with jaundice. Methods 22 children with biliary atresia (biliary atresia group) and 25 children with non-biliary atresia jaundice (non-biliary atresia group) were retrospectively analyzed. High frequency ultrasonic images of the state structure, The length, anterior and posterior diameter of gallbladder structure / gallbladder were compared between the two groups. Methods 1 (25 mm) and 2 (6 mm) were used to differentiate biliary atresia jaundice from non biliary atresia jaundice. Results there was no significant difference in the age of children with biliary atresia and non-biliary atresia (P0.05). The long diameter of cholecyst structure / gallbladder (16 卤8) mm and (29 卤7mm) in the biliary atresia group was shorter than that in the non-biliary atresia group (4 卤2) mm and (6 卤3) mm) (P0.05). Methods 1 the positive rate of biliary atresia jaundice was 82% (18 / 22) and that of non-biliary atresia jaundice was 88% (22 / 25). Methods the positive rate of biliary atresia jaundice was 91% (20 / 22) and that of non biliary atresia jaundice was 56% (14 / 25). There was no significant difference between the two methods in the detection rate of biliary atresia jaundice (蠂 20.77), and the detection rate of non-biliary atresia jaundice in method 1 was higher than that in method 2 (蠂 26.35 P 0.012). Conclusion Biliary atresia jaundice is similar to the long diameter of gallbladder structure / gallbladder, and the anteroposterior diameter is smaller than that of non-biliary atresia jaundice. High frequency ultrasound can clearly show the shape and structure of gallbladder, and it has good clinical value in differentiating the structure of gallbladder from that of normal gallbladder. The critical point of cholecyst structure / gallbladder length 25 mm can better distinguish biliary atresia jaundice from non biliary atresia jaundice.
【作者单位】：河北医科大学第二医院超声科;
【基金】：河北省医学科学研究重点课题计划(ZL20140026)
【分类号】：R725.7;R445.1

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