十二指肠引流液胆汁检测鉴别诊断婴儿肝炎与胆道闭锁的研究

十二指肠引流液胆红素定量及胆酸定性，鉴别婴儿肝炎（ＩＨ）或胆道闭锁（ＢＡ）。５６例日龄平均６３天的梗阻性黄疸婴儿共作十二指肠引流液检查７０次。十二指肠引流液最终胆汁阳性３０例，黄疸均消退，均符合ＩＨ；最终胆汁阴性２５例，手术均证实为ＢＡ；仅１例胆汁阴性者术中发现肝外胆管通畅但穿刺无胆汁，肝活检提示为毛细胆管性肝炎。十二指肠引流液胆汁检查与最后诊断的符合率为９８．２１％（５５／５６）。十二指肠引流液胆汁检测鉴别ＩＨ或ＢＡ简便、快速、安全、准确，是早期鉴别ＩＨ或ＢＡ具有特异性的诊断方法。

DETECTION OF BILE IN DUODENAL FLUID FOR DIFFERENTIATION OF BILIARY ATRESIA FROM INFANTILE HEPATITIS

From November 1988 to December 1992, the technique of detecting bilirubin and bile acids in duodenal fluid was practised in our hospital to differentiate infantile hepatitis ( IH ) from biliary atresia ( BA ) . Fifty six patients, mean age 63 days, presenting obstructive jaundice, underwent duodenal drainage 70 times. The final results revealed that 30 patients positive for bile in duodenal fluid were confirmed to have IH after the fading of their jaundice and 25 patients negative for duodenal bile were confirmed to have BA on surgical exploration. However, there was l bile negative patient in our series whose bile duct was found to be patent but void of bile on exploration and choledochal puncture. Liver biopsy later suggested this was a case of cholangiolar hepatitis. Thus the correctness of diagnosis made upon duodenal drainage was 98.2%(55/56 ) that of the final diagnosis, demonstrating that the procedure, simple and safe, helps differentiate IH from BA promptly and accurately.