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先天性胆总管畸形的患儿产前和产后具有不同的特征。

Different characteristics of infants diagnosed with congenital choledochal malformation prenatally or postnatally.

机构信息

Department of Radiology, Children's Hospital of Soochow University, Suzhou, 215025, China.

Clinical Laboratory, 3rd Hospital of Yulin City, Yulin, 719000, China.

出版信息

Sci Rep. 2021 Jan 8;11(1):20. doi: 10.1038/s41598-020-79569-4.

Abstract

The general condition, clinical and pathological characteristics, and treatment regimens of patients prenatally and postnatally diagnosed with congenital choledochal malformation (CM) were analyzed in order to investigate the clinical significance of early diagnosis, treatment, and intervention in CM. We retrospectively analyzed 33 children who were admitted to the Children's Hospital of Soochow University between 1 March 2010 and 31 May 2019, and their diagnosis of CM was confirmed by radiological, surgical and pathological findings. All the patients were under 36 months of age. The patients were divided into prenatally diagnosed and postnatally diagnosed groups. There were 16 and 17 CM patients in the prenatally and postnatally diagnosed groups, respectively, with a preponderance of females in both groups. Compared with the prenatally diagnosed group, the postnatally diagnosed group had a higher incidence of abdominal pain and vomiting (p < 0.05) and higher AST, GGT, and TB levels (p < 0.05). Although postoperative histopathological examination showed inflammation in both groups, congestion in the cyst walls and fibrous tissue hyperplasia were more significant in the postnatally diagnosed group (p < 0.05). In addition, operation time, length of time required to resume a normal diet after surgery, and total length of hospitalization differed between the 2 groups (p < 0.05), with the prenatally diagnosed group having a relatively longer operation time and taking longer to resume a normal diet after surgery. However, the total length of hospitalization in the prenatally diagnosed group was shorter than that in the postnatally diagnosed group. Compared with prenatally diagnosed CM patients, more symptoms, greater severity of symptoms, and more time to recovery after surgery were observed in postnatally diagnosed CM patients.

摘要

为探讨先天性胆总管囊肿(CM)早期诊断、治疗和干预的临床意义,分析了经产前和产后诊断为先天性胆总管囊肿的患者的一般情况、临床和病理特征以及治疗方案。我们回顾性分析了 2010 年 3 月 1 日至 2019 年 5 月 31 日期间在苏州大学附属儿童医院就诊的 33 例先天性胆总管囊肿患儿,其诊断均经影像学、手术和病理学证实。所有患者年龄均小于 36 个月。患者分为产前诊断组和产后诊断组。产前诊断组和产后诊断组各有 16 例和 17 例 CM 患儿,两组均以女性居多。与产前诊断组相比,产后诊断组腹痛和呕吐的发生率更高(p<0.05),AST、GGT 和 TB 水平更高(p<0.05)。尽管术后组织病理学检查显示两组均有炎症,但产后诊断组囊肿壁充血和纤维组织增生更为明显(p<0.05)。此外,两组的手术时间、术后恢复正常饮食的时间和总住院时间不同(p<0.05),产前诊断组的手术时间相对较长,术后恢复正常饮食的时间也较长。然而,产前诊断组的总住院时间短于产后诊断组。与产前诊断的 CM 患者相比,产后诊断的 CM 患者出现更多症状、更严重的症状和术后恢复时间更长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7378/7794410/1e0b655931d5/41598_2020_79569_Fig1_HTML.jpg

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