关键词: 胆道闭锁, 早期诊断, 临床特征

Abstract: Objective To investigate the clinical features of infants with biliary atresia (BA),improve the recognition of BA by pediatricians and the early diagnosis rate.Methods One hundred and forty children with BA confirmed by surgical cholangiography were chosen from Guangzhou Women and children's medical center in recent three years. The general clinical data, laboratory examination and imaging examination results of them were analyzed retrospectively. Results Most of the 140 cases were term infants with normal birth weight. The medium age of onset was 3.0(3.0,5.0)days, the medium initial visit time was 15.0(5.0,42.0)days. The first time of liver function examination was (47.23±22.09) days, and the time of operation diagnosis was (73.86±20.99) days. Only 36.43% of the patients discharged typical clay colored stool, 92.86% of them had hepatomegaly and hardened texture. Only 50.71% of the patients with GGT≥300 U·L^-1. After treatment, GGT of children with GGT<300 U·L^-1 increased significantly (P<0.05). Sixty-five 46.43% of BA patients were complicated with cytomegalovirus infection. The positive rate of hepatobiliary-ultrasound and MRCP to diagnose BA were 89.28%(125/140) and 70.73%(87/123) respectively.Conclusion BA is common in term infants. The liver function for the children whose jaundice is delayed or repeated should be checked as early as possible. During the diagnosis and treatment process, attention should be paid to liver and spleen examination, and dynamic observation should be made for children with atypical stool and GGT<300 U·L^-1. Hepatobiliary ultrasound combined with MRCP can improve the diagnosis rate.

Key words: Biliary atresia, Early diagnosis, Clinical feature