小肠闭锁两种术式比较(附71例临床分析)  

Comparison of the Effect of Two Surgical Methods of Congenital Intestinal Atresia: with Clinical Analysis of 71 Cases

作　　者：符策君[1] 董琦[1] 林海[1] 李权[1] 

机构地区：[1]海南省人民医院小儿外科,海口570311

出　　处：《医学综述》2014年第19期3638-3640,共3页Medical Recapitulate

摘　　要：目的对比分析肠切除、端端吻合术和肠切除、端端吻合术加吻合口近侧小肠悬吊造口术治疗先天性肠闭锁的疗效。方法选择2002年1月至2012年1月海南省人民医院收治的先天性小肠闭锁患儿71例,按手术方式不同分为两组:肠吻合组(30例)采用肠切除、端端吻合术治疗,肠吻合加悬吊造口组(41例)采用肠切除、端端吻合术加吻合口近侧小肠悬吊造口术治疗,观察两组患儿术后开始进食时间、住院时间及并发症情况。结果肠吻合加悬吊造口组治愈率高于肠吻合组(100.00%vs 86.66%),两组比较差异有统计学意义(P<0.05),肠吻合加悬吊造口组病死率显著低于肠吻合组(P<0.05);肠吻合加悬吊造口组术后开始进食时间和总住院时间显著优于肠吻合组(P<0.05)。结论肠切除、端端吻合术加吻合口近侧小肠悬吊造口术能减少术后吻合口漏的发生,提高新生儿先天性小肠闭锁的手术疗效,是治疗先天性小肠闭锁较理想的术式。Objective To compare the surgical effect between the traditional intestine resection ＋ anastomosis and traditional intestine resection ＋ anastomosis ＋ anastomotic proximal small intestine suspension ostomy to treat congenital intestinal atresia.Methods A total of 71 cases of congenital intestinal atresia admitted to Hainan Provincial People＇s Hospital from Jan.2002 to Jan.2012 were included in the study,who were divided into intestinal resection ＋ anastomosis group（30 cases） and intestinal resection ＋ anastomosis ＋ anastomotic proximal small intestine suspension ostomy group（41 cases）,the restart eating time after surgery,hospital stay and complications of the two groups were observed.Results Intestinal anastomosis ＋ suspension of colostomy group cure rate was higher than the intestinal anastomosis group（100％ vs 86.66％）,with statistically significant difference（P ＜ 0.05）,mortality of the intestinal anastomosis ＋ suspension of colostomy group was significantly lower thanthe intestinal anastomosis group（P ＜ 0.05）.The restart eating time and total hospitalization time of the intestinal anastomosis ＋ suspension of colostomy group was obviously better than the intestinal anastomosis group（P ＜ 0.05）.Conclusion The traditional intestine resection ＋ anastomosis ＋ enterostomy by intubation proximal to the anastomaic stoma can decrease the occurrence of postoperative anastomatic leakage and improve the curative effect,thus is a more ideal operation type.

关 键 词：肠闭锁 畸形 肠吻合术 

分 类 号：R726.1[医药卫生—儿科]