腹裂患儿Silo袋内肠管血供监测的方法探讨  

Monitoring the blood supply of the intestine in the Silo pouch for infants with gastroschisis using pulse oxymeter as a new method

作　　者：吴晔明[1] 洪莉[2] 严志龙[2] 顾松[2] 胡明[2] 

机构地区：[1]上海交通大学医学院附属新华医院,200092 [2]上海交通大学医学院附属上海儿童医学中心外科,200127

出　　处：《临床小儿外科杂志》2009年第5期22-23,27,共3页Journal of Clinical Pediatric Surgery

基　　金：本课题为2007年上海市级医院适宜技术联合开发推广应用项目,获上海市申康医院发展中心资助（项目号：SHDC12007228）

摘　　要：目的介绍一种针对无法一期回纳的严重新生儿腹裂患儿放置silo袋后监测袋内肠管血供的方法及其临床意义。方法对先天性腹裂患儿施行手术时，在Slio袋放置完毕后，将外周血氧饱和度监测仪的条带状探头紧贴硅胶袋壁包绕，监测硅胶袋内肠管血氧饱和度。结果5例无法一期回纳的新生儿腹裂患儿放置免缝Silo袋后成功应用外周血氧饱和度监测仪监测袋内肠管血供情况。结论外周血氧饱和度监测仪可安全应用于对Silo袋内肠管血供的监测，改变了以往仅仅依靠裸眼观察判断袋内肠管血供的欠准确科学的现状，避免了因袋内肠管嵌顿、缺血导致肠管缺血坏死的可能。Objective To introduce a new method of monitoring of blood supply of the intestine in the Silo pouch and to interpret its clinical significance. Methods After the Silo pouch was set in infant with gastroschisis, a pulse oxygmeter was fixed tightly around the pouch. If the monitor showed the arteriopalmus and blood oxygen saturation, it indicated that the intestine was not incarcerated and had a good blood supply. Results Five neonates with severe gastrosehisis that can not be closed by one-stage operation, were treated by setting a Silo pouch each, and using a pulse oxymeter saturation monitoring to monitor the blood supply of the intestine. Conclusions The pulse oxymeter can be used to monitor the blood supply of the intestine in the Silo pouch, instead of visual observation. It can help to reduce the incidence of incarceration and isehemia of the intestine and avoid the severe complication of intestinal necrosis.

关 键 词：腹裂/诊断 腹裂/治疗 婴儿 新生 

分 类 号：R726.56[医药卫生—儿科] R622.1[医药卫生—临床医学]