关键词: 先天性胆道闭锁, 围术期, 总胆红素, 脂溶性维生素缺乏, 预测

Abstract: 【Abstract】 Objective〓To explore the value of perioperative serum total bilirubin (TB) of children with congenital biliary atresia (CBA) predicting fat-soluble vitamin deficiency. Methods〓Seventy-two CBA babies in our hospital from January 2008 to June 2014 were selected as observation group, and 30 health babies in our hospital in the same period were selected as control group. The patients in observation group accepted surgical treatment and fat-soluble vitamin supplement. Serum levels of TB and bile acid (SBA), vitamin A, vitamin D, vitamin E, vitamin K in preoperative and postoperative 1 d, 3 d, 6 d, 12 d, 1 month, 3 months and 6 months were detected. Relationship between serum TB and SBA in CBA children and fat-soluble vitamin levels were analyzed, and value of serum TB and SBA level predicting fat-soluble vitamin deficiency was also analyzed. Results〓Preoperative and postoperative serum TB and SBA level of observation group higher than that of the control group(P<0.05). And postoperative 6 d or later serum TB and SBA levels of the observation group were lower than that of preoperative; And the difference was statistically significant (P<0.05). Compared with control group, perioperative serum fat-soluble vitamins level of observation group were lower; Compared with preoperative, postoperative one month or later serum fat-soluble vitamins level of observation group were increased. And the difference was statistically significant (P<0.05). Pearson correlation analysis results showed that the levels of serum TB and SBA in CBA babies were negatively correlated with serum fat-soluble vitamins level(P<0.05). ROC curve analysis results showed the area under the curve, sensitivity and accuracy of serum TB level of CBA infants predicting fat-soluble vitamin deficiency were higher than that of serum SBA level of CBA infants predicting fat-soluble vitamin deficiency(P<0.05). Conclusion〓Perioperative serum TB levels of CBA infants is high and the value of serum TB levels predicting fat-soluble vitamin deficiency is good. Serum TB can be used as reference in fat-soluble vitamin lack assessment of CBA infants and their treatment.

Key words: Congenital biliary atresia, Perioperative, Total bilirubin, Fat-soluble vitamin deficiency, Predict