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仅最近才有几位作者报道新生儿胆囊扩张,但提出的病因(如缺乏肠道喂养、败血症、肝静脉充血和暂时性胆囊运动机能障碍)假说很多,反映其病理生理学还存在很多推测。本文报道3例窒息新生儿暂时性胆囊扩张,并提出它与组织低氧有关的假说。病例例1,窒息男婴,42孕周剖宫产,出生体重4100g。生后1和5分钟Apgar评分分别为3和4。血pH7.16,硷丢失12.2。患婴并发痉挛、急性肾小管坏死、肠梗阻和尿潴留。产后第3天,右季肋部扪到一坚实质块达脐下水平。超声证实为胆囊扩张(4.6×2 cm)。第4天鼻饲人奶。第11天超声复查扩张消失。血中非结合胆红素延迟消退,但不严重。血培养(一)。例2、3从略
Only a few authors recently reported neonatal gallbladder dilatation, but many of the proposed hypotheses such as lack of gut feeding, sepsis, hepatic vein congestion and transient gallbladder motor dysfunction are numerous and reflect many of the speculations on their pathophysiology. This article reports three cases of neonatal asphyxia temporary gallbladder dilatation, and put it hypoxia associated with the hypothesis. Case 1, asphyxiated baby boy, 42 gestational weeks cesarean section, birth weight 4100g. Apgar scores at 1 and 5 minutes after birth were 3 and 4, respectively. Blood pH7.16, alkaline lost 12.2. Infant with convulsions, acute tubular necrosis, intestinal obstruction and urinary retention. On the third day postpartum, the right quarter of the ribs palpable to a solid block below the navel level. Ultrasound confirmed gallbladder dilatation (4.6 × 2 cm). Day 4 nasal feeding of human milk. Day 11 ultrasound disappeared. Unconjugated bilirubin delayed subsided, but not serious. Blood culture (a). Example 2,3 omitted