查詢結果分析
相關文獻
- Differential Diagnosis of Infantile Choledochal Cyst with or without Biliary Atresia
- Choledochal Cyst in Infancy: A Follow-up Study
- Long-Term Prognosis and Factors Affecting Biliary Atresia from Experience over a 25 Year Period
- Choledochal Cyst; Clinical Analysis and Review of Reports from Taiwan
- Value of γ-Glutamyl Transpeptidase for Early Diagnosis of Biliary Atresia
- 持續的黃疸及腹部逐漸脹大
- 先天性膽道閉鎖的護理照顧
- Clinical Application of Three-dimensional Cholangiography for Choledochal Cysts
- Percutaneous Management to Choledocho-Enterostomy Stricture Resulted from Complication of Choledochal Cyst Excision
- Successful Liver Transplantation in a Child with Biliary Atresia and Hepatopulmonary Syndrome
頁籤選單縮合
題名 | Differential Diagnosis of Infantile Choledochal Cyst with or without Biliary Atresia=嬰兒期膽道囊腫是否合併膽道閉鎖的鑑別診斷 |
---|---|
作 者 | 黃福辰; 黃高彬; | 書刊名 | 臺灣兒科醫學會雜誌 |
卷期 | 47:4 民95.07-08 |
頁次 | 頁175-180+213 |
分類號 | 417.5456 |
關鍵詞 | 膽道閉鎖; 膽道囊腫; 腹部超音波檢查; 肝膽核子醫學檢查; Biliary atresia; Choledochal cyst; Abdominal ultrasonography; Hepatobiliary scintigraphy; |
語文 | 英文(English) |
中文摘要 | 背景:嬰兒期膽道囊腫可能合併膽道閉鎖(BACH),然而單純的膽道囊腫(CH)及合併膽道閉鎖兩者卻有類似的臨床表現,但是不一樣的處理方式及預後。方法:從西元1991至2004年,我們回顧二十九位小於一歲應有術後確認膽道囊腫的嬰兒;其中十一位合併有膽道閉鎖,而十八位則是單純的膽道囊腫,二十九位病人都於術前接受腹部超音波檢查,其中十九位也接受肝膽核子醫學檢查。結果:經比較這兩組的臨床表現及實驗室檢查,我們發現BACH的病人有較高比例表現延遲性黃膽及灰白便,而且膽色素也較高。在腹部超音波診斷膽道閉鎖上,用肝外膽道囊腫的直徑小於等於1.5公分來取代萎縮的膽囊可使診斷的敏感度﹑特異性﹑正及負預測值均上升(81.8%﹑100%﹑100%﹑90% VS 54.5%﹑88.8%﹑75%﹑76.2%),因而提高了診斷的正確性(93.1% VS 75.9%)。而用肝膽同位素來診斷膽道閉鎖,其敏感度﹑特異性﹑正及負預測值及診斷正確性則分別為100%﹑70%﹑75%﹑100% 及84.2%)。結論:不同的致病機轉導致兩組病童有不一樣的臨床表現及實驗室上的差異,包括延遲性黃膽﹑灰白便﹑膽色素值以及膽道囊腫的大小。用膽道囊腫的直徑來取代萎縮的膽囊作為腹部超音波診斷膽道閉鎖合併嬰兒期膽道囊腫的標準可以增加診斷的正確性。另外,肝膽同位素攝影則可作為排除膽道閉鎖的診斷工具。 |
英文摘要 | Background: The choledochal cyst, a cystic dilatation of the biliary tree, in infancy may be associated with biliary atresia (BACH) or without biliary atresia (CH). Infants in both groups usually have similar clinical symptoms at presentation but different management and prognosis. Methods: We retrospectively identified 29 infants, aged younger than 1 year, who had surgically proven choledochal cysts from 1991 to 2004. They were diagnosed as CH in 18 patients and BACH in eleven. They had undergone preoperative abdominal ultrasonography (29 patients) and intravenous radionuclide cholangiography (IVRC) (19 patients). Results: The comparison of the clinical characteristics and laboratory examinations between the two groups showed that BACH patients had no sex predominance contrasting to female predominance in CH patients, more often presented with prolonged jaundice and clay-colored stool, and had higher bilirubin levels. In diagnosing BACH by ultrasonography, using the diameter of the extrahepatic cystic dilatation≦1.5 cm but not atretic gallbladder further increased the sensitivity, specificity, positive and negative predictive rates (81.8%, 100%, 100%, 90% vs 54.5%, 88.8%, 75%, 76.2%, respectively), yielding an increased diagnostic accuracy (93.1% and 75.9%, respectively). In diagnosing BACH by IVRC, the sensitivity, specificity, positive and negative predictive value and diagnostic accuracy were 100%, 70%, 75%, 100% and 84.2%, respectively. Conclusions: We concluded that there were clinical and laboratory discrepancies between the two groups, including female predominance, prolonged jaundice, clay-colored stool, bilirubin levels and size of cyst. In diagnosing BACH, the accuracy of abdominal ultrasonography will be increased if we use the diameter of the extrahepatic cystic dilatation≦1.5 cm but not atretic gallbladder as one of the diagnostic cretia. Hepatobiliary scintigraphy had less diagnostic accuracy than ultrasonography but can be added to exclude the diagnosis of BACH. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。