临床小儿外科杂志2016，Vol.15Issue(6)：566-569,574,5.DOI:10.3969/j.issn.1671-6353.2016.06.012
不同诊断入径对胆道闭锁诊治影响的探讨
Effects of different admission pathways on the diagnosis and treatment of biliary atresia
刘佳 1李胜 2吴颖 1卢雪心 1黄焱磊 1陈功 1郑珊1
作者信息
- 1. 复旦大学附属儿科医院 上海市，201102
- 2. 厦门市儿童医院 福建省厦门市，361006
- 折叠
摘要
Abstract
Objective To explore the effects of different admission pathways of internal medicine or sur-gery on the diagnosis and treatment of biliary atresia (BA). Methods From March 201 5 to March 201 6,273 obstructive jaundice patients with suspected BA and laparoscopic bile duct exploration were recruited.They were assigned into 2 groups by different admission pathways:237 cases admitted directly into surgical group while 36 cases internal medicine initially and then transferred into surgical group.Retrospective analyses were performed by operative age and preoperative hospitalization,accuracy of BA diagnosis,jaundice clearance (to-tal bilirubin <20 μmol/L)at 3 months after Kasai procedures and total hospitalization stay and expenditure. Results Among them,202 patients of surgical group and 26 patients of medical group were diagnosed as BA by laparoscopic bile duct exploration.The average operative age of surgical group was younger than that of medical group (66.50 ±20.52 d vs 72.58 ±27.01 d).While there was no statistical significance (P=0.31 9 6 >0.05 ).However,as compared with medical group,surgical group had shorter preoperative hospitalization (2.21 ±1 .1 2 d vs 6.85 ±3.52 d,P=0.000 0)and higher diagnostic accuracy of BA (85.23%vs 72.22%, P=0.050).Jaundice clearance at 3 months after Kasai procedure had no inter-group statistical difference (P>0.05).In surgical group,total hospitalization stay was much shorter (1 8.07 ±5.62 d vs 21.63 ±3.92 d,P<0.000 1 )and the expenditure was lower (34 1 54.66 ±7 457.43 yuan vs 39 657.52 ±6 1 63.36 yuan,P<0.000 1 )than medical group. Conclusions Different admission pathways of internal medicine or surgery have shown not much effect on the operative age of BA patients.But admission into surgery department can help shorten hospitalization stay and reduce hospitalization experditure.关键词
胆道闭锁/诊断/治疗/腹腔镜检查Key words
Biliary Atresia/Diagnosis/Therapy/Laparoscopy引用本文复制引用
刘佳,李胜,吴颖,卢雪心,黄焱磊,陈功,郑珊..不同诊断入径对胆道闭锁诊治影响的探讨[J].临床小儿外科杂志,2016,15(6):566-569,574,5.
