用硅胶袋修复巨型脐膨出与腹裂13例报告  

Application of silica gel bag staged repair abdominal wall deficiency

作　　者：刘翔[1] 郑训淮[1] 戚士芹[1] 叶桓[1] 左伟[1] 黄河[1] 

机构地区：[1]安徽省立儿童医院外科,合肥230051

出　　处：《临床小儿外科杂志》2007年第3期19-20,共2页Journal of Clinical Pediatric Surgery

摘　　要：目的总结应用硅胶袋分期修复巨型脐膨出和腹裂的治疗经验。方法回顾性分析2003年以来应用硅胶袋进行分期腹壁修补术的11例患儿病例资料。其中巨型脐膨出3例,腹裂8例。均于气管插管全身麻醉下手术,将无菌硅胶袋与腹壁缺损边缘缝合成囊袋状,包裹膨出的脏器,术后逐渐挤压囊袋至内脏还纳入腹腔后去除囊袋,分层关闭腹壁缺损。脐膨出患儿行脐部成形。全部患儿术后均予呼吸机支持2～24h。结果全组患儿膨出脏器均于术后7～10d还纳入腹腔,此时腹壁无明显张力,术后无腹壁切口裂开及腹腔继发感染,伤口恢复良好,生长发育正常。结论采用无菌硅胶袋替代涤纶补片行腹壁修补术,硅胶袋与腹壁缝合后反应小,费用低,是一种安全、疗效可靠的方法。Objective To introduce the experience of staged silica bag （silo） repair for neonatal giant omphalocele and gastroschisis. Method The clinical data of silo bag staged repair for 3 cases of neonatal giant omphalocele as well as 8 cases of gastroschisis since 2003 were retrospectively analyzed. All patients were treated under general anesthesia with trache cannula. Sterile silo bag and defect rim of abdominal well was sutured to form a sac like bag, which wrapped the protruding viscera at an extra abdominal cavity. Postoperation, the protruding viscera was gradually crushed into abdominal cavity, and then we removed the bag and closed the defect of abdominal wall. Results In all patients the protruding viscera were placed in abdominal cavity between the 7 and 12 days postoperation. At this time the abdominal wall had not obviously tension, so the defect was closed by two-stage. Postoperative mechanical ventilation was given from 2 to 24 hours. All patients were recovered well without abdominal wound disruption and secondary infection in abdominal cavity. The growth and development of patients is normal. Conclusion Compared with terylene patch, light reaction caused by silo bag when abdominal wall was sutured and operation cost is lower. This method is a reliable, safe and effective approach to repair the neonatal omphalocele and gastroschisis.

关 键 词：疝 脐/外科学 腹裂/外科学 弹性聚硅酮类 

分 类 号：R726.5[医药卫生—儿科]