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目的:探讨小儿胰腺炎与胰胆管合流异常的关系。方法:选择0-10岁患有胰腺炎的儿童128例,发病时抽取其静脉血,检测丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TB)、碱性磷酸酶(ALP),γ-谷氨酰转移酶(GGT),保守治疗10d复查;术中以胆道造影技术观察其胰胆管合流是否异常。结果:对128例患儿行胆道造影,发现胰胆管合流异常36例。临床保守治疗后,胰胆管合流异常组和非胰胆管合流异常组的肝功能(ALT、AST、TB、ALP、GGT)都有明显降低,差异具有显著统计学意义(P<0.01)。经10d保守治疗后,患儿的TB、ALP均恢复正常,胰胆管合流异常组仍高于非胰胆管合流异常组,但差异不具有统计学意义(P>0.05);胰胆管合流异常组的ALT、AST、GGT均高于非胰胆管合流异常组,差异有统计学意义(P<0.05)。结论:胰胆管合流异常是导致小儿胰腺炎的重要原因之一。
Objective: To investigate the relationship between pancreatitis and pancreaticobiliary duct anomalies in children. Methods: A total of 128 children with pancreatitis from 0 to 10 years old were enrolled in this study. Venous blood samples were taken from the patients at the onset of the disease. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin TB), alkaline phosphatase (ALP) and γ-glutamyltransferase (GGT) were treated with conservative treatment for 10 days. The intraoperative cholangiography was used to observe whether the anastomotic pancreaticobiliary duct was abnormal. Results: Thirty-eight children underwent cholangiography and 36 cases were found to have abnormal pancreaticobiliary junction. After conservative treatment, the abnormal liver function (ALT, AST, TB, ALP, GGT) in patients with abnormal pancreaticobiliary junction and non-pancreaticobiliary anastomosis were significantly reduced (P <0.01). After 10 days of conservative treatment, children with TB, ALP were back to normal, abnormal pancreaticobiliary junction is still higher than the non-pancreaticobiliary anomalies, but the difference was not statistically significant (P> 0.05); pancreaticobiliary anomalies ALT, AST, GGT were higher than non-pancreaticobiliary duct anomalies, the difference was statistically significant (P <0.05). Conclusion: The abnormal pancreaticobiliary junction is one of the important causes of pancreatitis in children.