Steroid Evaluation In Diagnosis, Differential Diagnosis And Therapy Of Biliary Atresia

BackgroundBiliary atresia (BA) is serious and fatal, and is one of the most common cause for infant obstructive jaundice, and the major hepatic disease that causes infant death. The incidence of BA in the world is 1/10,000～1/14,000, and 1/8,000～1/15,000 in china. The treatment of BA is mainly early operation, and the best operative time is 40～60 days after birth. Survival rate, that is accepted operation within 60 days afterbirth, is higher, and which, that is accepted operation after 90 days afterbirth, is lower. If haven't operation, patient can't surpass one year of life time. Prompt diagnosis and treatment will largely affect the infants, survival qualities, which may havegreat significance.ObjectiveTo evaluate the value of steroid in differential diagnosis and therapy of neonatal obstructive hepatitis and biliary atresia.MethodsThe clinical data of 36 children with obstructive jaundice, who had accepted steroid therapy from 2009 to November 2010, were restrospectively analyzed. During the same period, clinical data of 32 children with obstructive hepatitis were collected as controls. Both groups are given antivirus, protect liver and vitamin drugs therapy in early stage, and hormone group combined with Steroid. We compared the variation of Bilirubin and enzymology, efficient of conservative treatment, negative rate of perirenal abscess, rates of jaundice, survival rates of the native liver, and the occurrence of cholangitis between the two groups. We also analyzed the steroid-related complications. All data were reported as mean±SD. Statistical test was performed usingχ2 test or t test. Results were considered statistically significant if P value was less than 0.05. Statistical process was used by SPSS 17.0 for Windows software.ResultsConservative treatment for two weeks, the efficient was 38.89% in hormone group, and 28.13% in control group, There was no difference between the two groups before conservative treatment, but obvious difference after conservative treatment, and the reduction of hormone group was higher than that of the control group (P<0.05). After conservative therapy, the better patients Continue to treat as before, and the worse patients were given perirenal abscess. Compared with controls, negative rate for biliary atresia of honnone group was lower than that of the hormone group (P<0.05). Six months after operation, the rate of jaundice clearance was 65% in hormone group, while it was 28.57% in control group (P<0.05). The occurrence of cholangitis in hormone group was 30%, while it was 64.86% in control group respectively (P<0.05)ConclusionSteroid was useful in differential diagnosis between neonatal obstructive hepatitis and biliary atresia.①Hormone intervention in early stage can effectively identify biliary atresia from neonatal obstructive hepatitis disease. The children for obstructive jaundice hepatitis, who had been cued with steroid, avoided eventually damages which were caused by Perirenal abscess.②steroid can promote effectively the bile flow an, cause jaundice disappear, and reduce the rate of cholangitis.