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目的探讨超声在先天性囊肿型胆道闭锁和胆总管囊肿鉴别诊断中的价值。方法回顾性分析超声发现肝门区的囊肿并接受手术治疗的患儿53例,根据手术结果分为闭锁组和胆囊肿组,总结两组超声的特点,比较两组观测指标的差异。结果闭锁组囊肿的体积(2.55±2.31)cm~3,明显小于胆总管囊肿组(56.06±101.79)cm~3(t=3.482,P=0.01)。闭锁组胆囊收缩功能不良率(89%),明显高于胆总管囊肿组(2.6%);闭锁组肝门部纤维块发生率(77%),明显高于胆总管囊肿组(0%);闭锁组肝内胆管扩张发生率、囊肿内胆泥沉积率低于胆总管囊肿组。结论超声发现婴儿肝门区囊肿,可根据囊肿的体积、壁厚、胆囊收缩功能、肝内胆管扩张等鉴别诊断。
Objective To investigate the value of ultrasound in the differential diagnosis of congenital cystic biliary atresia and choledochal cyst. Methods A retrospective analysis of 53 cases of children with cysts in the hilar region was performed. According to the results of surgery, the patients were divided into atresia group and gallbladder cyst group. The characteristics of the two groups were summarized. The differences of the two groups were compared. Results The volume of the cyst in the atresia group (2.55 ± 2.31) cm ~ 3 was significantly lower than that in the choledochal cyst group (56.06 ± 101.79) cm ~ 3 (t = 3.482, P = 0.01). The failure rate of gallbladder systolic dysfunction (89%) in the occlusion group was significantly higher than that in the choledochal cyst group (2.6%). The incidence of hepatic portal fibrosis in the occlusion group (77%) was significantly higher than that in the choledochal cyst group (0%). The incidence of intrahepatic bile duct dilatation in the occlusion group was lower than that in the common bile duct cyst group. Conclusion Ultrasound found in infantile hilar area cyst, according to cyst size, wall thickness, gallbladder contractility, intrahepatic bile duct dilatation differential diagnosis.