天津医药

天津医药 ›› 2019, Vol. 47 ›› Issue (4): 346-350.doi: 10.11958/20190643

• 专题研究·胆道闭锁与肝移植 • 上一篇    下一篇

胆管板畸形对胆道闭锁患儿自体肝生存的影响

张辉 1，林松 2，熊希倩 3，闫学强 3，余晨 3，高伟 4，胡晓丽 5，赵丽 5，詹江华 1△   

  1. 1天津市儿童医院普外科（邮编300134）；2乌鲁木齐儿童医院泌尿外科；3天津医科大学研究生院；4天津市第一中心医院移植 科；5天津市儿童医院病理科
  • 收稿日期:2019-03-08 修回日期:2019-03-30 出版日期:2019-04-15 发布日期:2019-05-27
  • 通讯作者: 詹江华 E-mail:zhanjianghuatj@163.com
  • 作者简介:张辉（1985），女，硕士，住院医师，主要从事小儿外科、胆道闭锁方面的研究
  • 基金资助:
    国家自然科学基金资助项目;天津市卫生行业重点攻关项目

The impact of ductal plate malformation on autologous liver survival in children with biliary atresia

ZHANG Hui1, LIN Song2, XIONG Xi-qian3, YAN Xue-qiang3, YU Chen3, GAO Wei4, HU Xiao-li5, ZHAO Li5, ZHAN Jiang-hua1△   

  1. 1 Department of Pediatric Surgery, Tianjin Children’s Hospital, Tianjin 300134, China; 2 Department of Urological Surgery, Urumqi Children’s Hospital; 3 Graduate School of Tianjin Medical University; 4 Department of Pediatric Liver Transplantation, Tianjin First Center Hospital; 5 Department of Pathology, Tianjin Children’s Hospital
  • Received:2019-03-08 Revised:2019-03-30 Published:2019-04-15 Online:2019-05-27
  • Contact: zhanjianghua E-mail:zhanjianghuatj@163.com

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摘要： 目的 分析胆管板畸形（DPM）与胆道闭锁（BA）患儿自体肝生存的关系。方法 收集 2008年 1月—2017 年12月在天津市儿童医院行Kasai手术，在天津市第一中心医院行肝移植（LT）的BA患儿40例。对Kasai术及LT时 的肝组织进行 HE染色及 CK19免疫组化染色，按照不同时期 DPM存在情况进行分组，Kasai术时无 DPM组（27例）， 有DPM组（13例）；LT时无DPM组（17例），有DPM组（23例）。分别比较不同阶段各组患儿自体肝生存时间差异。结 果 Kasai术时有 DPM组和无 DPM组 BA患儿自体肝生存时间分别为 230.0（190.5，276.5）d和 336.0（218.0，757.0）d； LT 时有 DPM 组和无 DPM 组 BA 患儿自体肝生存时间分别为 230.0（185.0，285.0）d和 527.0（288.0，817.0）d。无论是 Kasai术还是LT时，有DPM患者的自体肝生存时间均较无DPM明显缩短（P＜0.05）。结论 胆道闭锁患儿伴发胆管 板畸形可能会影响到自体肝生存时间。

关键词: 胆道闭锁, 肝移植, 胆管板畸形, Kasai手术, 自体肝生存

Abstract: Objective To analyze the relationship between bile ductal plate malformation (DPM) and autologous liver survival in children with biliary atresia (BA). Methods A total of 40 BA children underwent Kasai operation in Tianjin Children’s Hospital and liver transplantation (LT) in Tianjin First Central Hospital from January 2008 to December 2017 were collected. Hepatic tissue samples at the time of Kasai operation and liver transplantation were stained with HE and CK19 immunohistochemistry. According to the existence of DPM in different periods during Kasai operation, patients were divided into without DPM group (n=27) and with DPM group (n=13), and without DPM group (n=17) and with DPM group (n= 23) during liver transplantation. The differences of autologous liver survival time were compared between different stage groups of children. Results The autologous liver survival time was 230.0 (190.5, 276.5) d and 336.0 (218.0, 757.0) d respectively in BA children with and without DPM during Kasai operation. The autologous liver survival time was 230.0 (185.0, 285.0) d and 527.0 (288.0, 817.0) d respectively in BA children with and without DPM during liver transplantation. The autologous liver survival time was significantly shorter in patients with DPM than that in patients without DPM either during Kasai operation or LT (P＜0.05). Conclusion Children with biliary atresia associated with bile ductal plate malformation can shorten their autologous liver survival time.

Key words: biliary atresia, liver transplantation, ductal plate malformation, Kasai operation, survival with native liver