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摘要目的:总结小儿胆总管囊肿CCC的诊治经验。方法:对我院92例CCC的临床资料作回顾性分析。结果:本组肝硬化的发生率为23%21/92,其中2岁以下占71%15/21,2岁以上占29%6/21,两者比较差异有显著性P<0.05。90例68例Ⅰ期、22例Ⅱ期行囊肿切除及胆肠鲁氏Y型RouxenY吻合术,2例仅作外引流术。89例治愈,1例好转,1例死亡,1例放弃治疗。长期行外引流者肝功能恢复慢,影响生长发育。4例经全胃肠外营养TPN治疗平均引流24日后,顺利行Ⅱ期根治术。结论:CCC应行囊肿切除及胆肠鲁氏Y型吻合术。2岁前发病者易合并肝硬化,应重视婴幼儿的早期诊断治疗,以减少肝硬化的发生率。外引流术后作TPN治疗可缩短引流的时间。
Abstract Objective: To summarize the diagnosis and treatment of CCC in children with choledochal cyst. Methods: The clinical data of 92 cases of CCC in our hospital were retrospectively analyzed. Results: The incidence of liver cirrhosis in this group was 23% 21/92, of which 71% of the patients under 2 years old and 21 of 21 years old accounted for 29% 6/21, the difference between the two groups was significant P <0.05. 90 cases 68 cases of stage Ⅰ, 22 cases of stage Ⅱ cyst excision and Roux enteral Roux Y Y anastomosis, 2 cases were only for external drainage. 89 cases were cured, 1 case improved, 1 case died, 1 case gave up treatment. Long-term external drainage of patients with slow recovery of liver function, affecting growth and development. Four cases of total parenteral nutrition TPN treatment of the average drainage 24 days, the successful line Ⅱ radical mastectomy. Conclusion: Cyst excision and cholecystolithiasis Y-type anastomosis should be performed in CCC. 2 years before the onset of susceptible cirrhosis, should pay attention to the early diagnosis and treatment of infants and young children to reduce the incidence of cirrhosis. TPN treatment after external drainage can shorten the drainage time.