胸腹连体儿分离术后成功救治一例  

Medical treatment following successful separation of thoracopagus conioined twins

作　　者：赵春[1] 韩波[1] 孙正芸[1] 孙文秀[1] 杨波[1] 刘锦纷[4] 鲁亚男[4] 王安彪[2] 吴荣德[3] 

机构地区：[1]山东大学附属省立医院儿科, 济南250021 [2]山东大学附属省立医院心外科, 济南250021 [3]山东大学附属省立医院儿外科, 济南250021 [4]上海交通大学附属上海儿童医学中心

出　　处：《中华儿科杂志》2012年第3期216-218,共3页Chinese Journal of Pediatrics

摘　　要：目的 探讨胸腹连体儿分离手术成功后的内科治疗经验.方法 分析一对胸腹连体女婴的临床表现和诊治经过.该胸腹连体女婴白胸部乳头水平上5 cm至脐部联体,合并复杂性先天性心脏病.于生后17 d行胸腹联体畸形分离术,术后A婴死亡,B女婴出现严重的心力衰竭、脓毒症、多脏器功能损害（肝脏、血液、肾脏）等并发症,除加强患儿生命体征的监护外,通过加强客观指标的检测,如血常规、C反应蛋白、肝功生化、血培养、痰培养、G试验和GM试验、血气分析、胸片等,早期发现和控制感染,及时了解患儿各脏器的功能状态,保护重要脏器功能.结论 心血管畸形、呼吸衰竭、严重感染是胸腹连体儿分离术后常见的死亡原因；预防和控制感染、保护重要脏器功能至关重要；尽早纠治先天性心脏病可以提高患儿存活的可能性.Objective To analyze and summarize the medical treatment experience following separation of thoracopagus conjoined twins.Method The clinical manifestations and the medical therapy of a pair of thoracopagus conjoined twins were analyzed. The conjunction of the female twins was from 5 cm above the nipple to the umbilicus.They also suffered from complex congenital heart diseases.At the 17th day of their lives,they were surgically separated.One girl died after the operation,the other survived but experienced heart failure,sepsis and multiple organ dysfunction （ including liver,blood and kidney et c.）.In order to protect or maintain the main organ function,the vital signs and the objective indexes were monitored continually, such as blood routine test, C reactive protein, hepatorenal function, bacterial culture,and galactomannan test,blood gas analysis and chest radiogram.Conclusion It is important to protect the main organ function and prevent or control infection.The early surgical correction of congenital heart disease may contribute to recovery of the children.

关 键 词：双生 连体 新生儿重症监护病房 婴儿 新生 

分 类 号：R726.5[医药卫生—儿科]