先天性十二指肠梗阻的治疗效果观察  

Effect observation of treatment of congenital duodenal obstruction

作　　者：王瑛[1] 

机构地区：[1]洛阳市妇女儿童医疗保健中心外科,河南洛阳471000

出　　处：《医药论坛杂志》2013年第3期62-63,共2页Journal of Medical Forum

摘　　要：目的探讨提高新生儿先天性十二指肠梗阻治愈率的方法。方法总结近8年收治的66例新生儿先天性十二指肠梗阻的临床资料。对术前诊断、病理类型、手术时机、手术方法及围手术期管理进行回顾性分析。结果 66例患儿均于术前行直立位腹平片及上消化道泛影葡胺造影检查,17例行泛影葡胺下消化道造影检查。所有患儿均行手术治疗,其中十二指肠闭锁及狭窄4例,环状胰腺18例,十二指肠膈膜7例,单纯肠旋转不良15例,复合型18例,全小肠扭转4例,其中2例因全小肠坏死死亡,术后有2例患儿因先天愚型,家人放弃进一步治疗,余62例患儿均痊愈出院,治愈率达94%。结论术前X线检查是诊断先天性十二指肠梗阻最有效,早期诊断,合理选择手术时机及手术方法,注意合并病变,避免漏诊,加强围手术期管理是提高治愈率的关键。Objective To improve the cure rate of neonatal congenital duodenal obstruction method. Methods In our hospital in recent 8 years in 66 cases of neonatal congenital duodenal obstruction clinical data. The prebperative diagno- sis, pathological types, operation time, operation method operation and perioperative management were retrospectively analyzed. Results In all 66 cases before operation upright abdominal plain film and upper gastrointestinal angiografin or iodine oil radiography examination, 17 cases of meglumine diatrizoate lower gastrointestinal contrast examination. All patients were treated with operation, duodenal atresia and stenosis in 4 cases, annular pancreas in 18 cases, duodenal diaphragm in 7 cases, 15 cases of simple intestinal malrotation, composite type in 18 cases, total of 4 cases of small in- testine volvulus, which in ：2 cases because of the entire small intestine necrosis death, there were 2 postoperative cases with congenital fool type, family give up further treatment, 62 cases were cured, the cure rate was 94%. Conclusions Preoperative X ray diagnosis of congenital duodenal obstruction is most effective, and most direct method. In early diag- nosis, the appropriate choice of operation and operation methods, attention to the combined lesions, to avoid missed di- agnosis, strengthen peri operation period management is the key to raise the cure rate.

关 键 词：十二指肠梗阻 诊断 手术治疗 

分 类 号：R656.64[医药卫生—外科学]