非麻醉下床边应用免缝Silo袋处理新生儿腹裂  

Application a silastic spring-loaded silo for infants with gastroschisis without anaesthesia NICU

作　　者：吴晔明[1] 陈其民[1] 诸君[1] 洪莉[1] 严志龙[1] 顾硕[1] 

机构地区：[1]上海第二医科大学附属新华医院上海儿童医学中心,200127

出　　处：《中华小儿外科杂志》2005年第10期533-535,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的介绍非麻醉状态下于床边应用免缝Silo袋分期处理无法I期关闭的新生儿腹裂。方法2004年3月和7月,收治2例新生儿腹裂,分别出生后2h和4h,1例肠管污染严重,另1例合并有肠旋转不良和胎粪性肠梗阻,2例均在清醒状态下于NICU床边应用免缝Silo袋I期处理无法回纳腹腔的肠管,2例分别于第6d和第7d在肠管完全回纳腹腔后至手术室全麻下行腹壁关闭脐部成形术,其中例2同期行Ladd′s术和肠内胎粪清除术。结果2例患儿术后恢复好,脐部Ⅰ期愈合,分别随访5个月和2个月,生长发育好。结论非麻醉状态下床边应用免缝Silo袋分期处理无法I期回纳的新生儿腹裂是一简便安全的方法,并可推广至产房早期处理腹裂患儿,将有效减少患儿肠管的继发性水肿和炎症,提高生存率。Objective To introduce a new technique which using a silastic springloaded silo （SLS） for infants with gastroschisis with no anaesthesia in NICU. Methods Between March and July, 2004, two infants with gastroschisis were treated successfully in Shanghai Children＇s Medical Center using silastic SIrS under non anaesthesia bedside in NICU. One baby was only 4 hours after birth at admission, another had associated intestinal malrotation and meconium ileus was 2 hours after birth. Both of them underwent SIrS closure at bedside in NICU. When the bowel was completely reduced, a second-stage closure was performed in the operating-room under general anaesthesia. One of two underwent the Ladd＇s procedure and cleaning of meconium ileus. Results Two infants recovered well after operation and were follow up for five months and two months repectively. They are all alive and well. Conclusions Non-anaesthesia bedside SLS for the infants with gastroschisis is a simple and save method. It will reduce the chance infection and increase the survival rate, if applied in the deliveryroom.

关 键 词：新生儿 腹裂 免缝Silo袋 新生儿腹裂 床边 非麻醉下 胎粪性肠梗阻 2004年3月 麻醉状态下 Ⅰ期愈合 

分 类 号：R726.5[医药卫生—儿科]