肠旋转不良的治疗及教训分析  

The Experiences and Lessions in Treatment of Intestinal Malrotation

作　　者：吴文华 谭建中 丘禹洪 王恩礼 林启发 

机构地区：[1]广东省深圳市妇女儿童医院小儿外科,518028

出　　处：《中国误诊学杂志》2001年第7期961-962,共2页Chinese Journal of Misdiagnostics

摘　　要：目的　报告我院手术治疗先天性肠旋转不良的经验及教训。方法　回顾性分析我院 1987～ 2 0 0 0年诊断及治疗 17例先天性肠旋转不良的临床经过。结果　男 10例 ,女 7例 ,年龄从生后第 1天～ 7岁 (平均年龄 10个月 ) ,均作L add′s手术。其中新生儿 10例 ,同时并有肠闭锁、膈疝、胃大弯破裂、胃穿孔、肠扭转各 1例 ,环形胰腺 2例 ,其中 1例胃大弯破裂并环形胰腺及肠旋转不良。本组 5例需再次手术 ,原因为忽略性环胰、十二指肠索带松解不充分等。无 1例死亡。15例获得远期随访 ,时间为 3～ 13a,平均 7a。结论　对先天性肠旋转不良以及可能并发的畸形有充分认识和了解 ,避免误诊 ,以及手术中作出妥善处理 ,是避免再次手术的关键。Objective To present our experiences and lessions in operative treatment of intestinal malrotation and associated malformations.Methods From 1987 to 2000,17 cases with intestinal malrotation were analysed retrospectively.Results Of them,10 boys and 7 girls(age range:first day～7 years,mean age:7 months,10 newborn)underwent Ladd′s procedure.5 cases assorciated with jejunal atresia.diaphragmatic hernia,stomach rupture,stomach perforation,and intestinal volvulus respectively.2 cases associated with annular pancreas(1 with stomach rupture,annular pancreas and malrotation).5 cases required reoperations becauses of neglected annular pancreas and uncompleted mobilization of the duodenum etc.None died.15 cases were followed up for 3～13 years,mean 7 years.Conclusions The knowledge of intestinal malrotation and associated malformations,and the corrective management in the operations are main points to avoid reoperation.

关 键 词：肠旋转不良 并发畸形 再次手术 儿童 

分 类 号：R726.56[医药卫生—儿科]