新疆地区先天性腹裂诊治状况  

Diagnosis of treatment on congenital gastroschisis in Xinjiang

作　　者：王皓洁 林峰 詹江华[2] 刘志杰 李鑫 祖力帕尔·雪合热提 阿里木江·阿不都热依木 WANG Hao jie;LIN Feng;ZHAN Jiang hua;LIU Zhi jie;LI Xin;ZU II PA ER·Xue he re ti;A li mu jiang·A bu du re yi mu(Department of Pediatric Surgery and Neonatal Surgery,Xinjiang Urumqi Children's Hospital,Urumqi,Xinjiang 830002,China;Department of Pediatric Surgery,Tianjin Children's Hospital,Tianjin 300134,China)

机构地区：[1]新疆乌鲁木齐市第一人民医院(儿童医院)小儿普外科,新生儿外科,乌鲁木齐830002 [2]天津市儿童医院普外科,天津300134

出　　处：《新疆医学》2018年第11期1190-1194,共5页Xinjiang Medical Journal

摘　　要：目的总结近10年来新疆部分地区先天性腹裂诊治状况。方法回顾性分析2007年-2017年间本院收治新疆地区先天性腹裂疾病22例患儿临床资料、手术方式及随访情况。结果 22例中,男性16例,女性6例;生后即刻来院就诊。所有患儿均行手术治疗:12例行I期腹壁修补术;6例行人工成形皮肤疝腹壁修补术;4例行自制Silo袋腹壁修补术,于术后2周行Ⅱ期修补关闭腹壁。术后1例患儿因腹腔内感染导致多器官功能衰竭死亡;1例患儿合并肠旋转不良,于术后第10天行二次手术,术中发现回肠穿孔,行肠造口术,6个月后行关瘘。术后随访(6～24)个月,20例患儿目前体重和身高等发育正常,1例合并肠旋转不良患儿随访2年,生长发育迟缓。结论腹裂患儿应针对脱出脏器多少选择合适的手术方式,注意伴发畸形处理,从而降低术后死亡率。Objective To summary the status about the diagnosis and treatment of congenital gastroschisis in parts of Xinjiang during the past 10 years. Methods Clinical data, surgical methods and follow-up data of 22 patients with congenital gastroschisis in Xinjiang were analyzed retrospectively from 2007 to 2017. Result Among the 22 cases, 16 were male and 6 were female. They came to the hospital immediately after their birth. All patients underwent surgical treatment: abdominal repair was performed in phase I in 12 cases;6 cases underwent artificial excision and repair of the abdominal wall;and 4 cases underwent self-made repair of the abdominal wall of Silo bag, and a phase II repair was performed to close the abdominal wall after 2 weeks. One patient died of multiple organ failure due to the intraperitoneal infection after surgery. One patient with malrotation of intestine underwent secondary surgery on the 10 th day after surgery,and intestinal perforation was found during operation and enterostomy was performed. The operation of closing the fistula was performed 6 months later. The time of follow-up was 6 ~ 24 months, 20 patientaswith normal weight and height, 1 case with malrotation of intestine was followed up to 2 years and the development was delayed. Conclusion Children with abdominal fissure should choose appropriate surgical methods according to the number of organs removed, and pay attention to the treatment of concomitant deformities, so as to reduce the mortality rate after operation.

关 键 词：新生儿 腹裂 手术方式 死亡率 

分 类 号：R722[医药卫生—儿科]