摘要
采用定量方法，对手术证实的２０例胆道闭锁和３例新生儿肝炎患儿肝脏病理组织学进行观察研究。发现胆道闭锁肝脏的主要特征性病变为胆管明显增生。并提出平均３个汇管区胆管增生数目在１５个以上，大部分小叶间、小叶内胆栓数目在２～３个以上，结合参考多核巨肝细胞、间质增生成分、炎性细胞浸润程度及胆汁性肝硬化等变化即可确诊为胆道闭锁。另外，通过对２０例胆道闭锁不同年龄组肝脏病理组织学比较观察，发现２月内年龄组病人与２月后患儿，肝脏形态学变化没有明显差异。从而认为胆道闭锁预后与手术时令关系不大，而与肝脏病变程度有关。从病理学角度提示在手术的选择上，年龄应提前至３０天以前；术前月龄超过２个月患儿，应经皮肝穿活检，观察肝脏病理形态学变化，那些病变为严重不可逆肝硬化者应放弃手术。
The histopathological changes of liver in 20 patients with biliary atresia(BA) and 3 patients with neonatal hepatitis proved by surgery were observed. The results showed that the predominant alteration of BA was distinct hyperplasia of biliary duct.It was presentened that the cases in which the average of proliferative biliary tube was more than 15 in three portal areas, the number of most intralobula and interlobula bile thrombus was more than 2 to 3, combining with the multinuclear giant liver cell,the contents of interstitial proliferation, the inflammatory degree of inflammatory cell and the changes of biliary cirrhosis of liver,might be considered the biliary atresia. In addition,it was not different in histopathological alterations between the cases within 2 months and over 2 months. It is suggested that the prognosis of BA is not associated with the time of operation, but with the extent of pathological changes. From the point of the pathology, the patients with BA should be operated before 30 days. The transcutaneous intrahepatic biopsy should be performed in patients who is over 2 months before operation, If the changes of liver was the severe biliary cirrhosis, the operation should be given up.
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
1996年第3期196-199,共4页
Chinese Journal of Clinical and Experimental Pathology
