新生儿先天性腹裂外科处理后转归  

Clinical outcome of neonates with congenital gastroschisis after surgical treatments

作　　者：严文波[1] 潘伟华[1] 武志祥[1] 许小幸[1] 施诚仁[1] 王俊[1] 

机构地区：[1]上海交通大学医学院附属新华医院小儿外科,200092

出　　处：《临床外科杂志》2016年第11期879-881,共3页Journal of Clinical Surgery

摘　　要：目的提高先天性腹裂的诊断与治疗水平。方法先天性腹裂患儿30例,按病变严重度及合并畸形分单纯及复杂二组,采用两种不同外科干预方式:Ⅰ期修补术和Silo袋置袋后Ⅱ期修补术。这两种模式中均有产房外科早期干预患儿。结果先天性腹裂单纯组均可Ⅰ期手术7例(其中含1例双胎腹裂),存活率100%;复杂组中23例,除8例家长放弃治疗外,均行Silo袋置袋术及Ⅱ期修补术,成活率66.7%。5例死亡原因是严重腹腔感染、多脏器功能衰竭。结论Ⅰ期修补手术患儿已无死亡率,产房外科早期干预手术值得推广,Silo袋为提高腹裂患儿Ⅱ期手术修补的成功起到重要的作用。Objective Raise the level of diagnosis and treatment of congenital gastroschisis. Methods We retrospectively analyzed 30 gastroschisis neonates. Based on the severity of gastroschisis and combined malformation,these patients were divided into two groups,simple group and complex group. Two different intervention methods were performed,one-stage repair and silo bag placement and second-stage closure. Both methods including the cases underwent early intervention of delivery room surgery. Re-sults All of 7 patients from simple group underwent one-stage surgery,including a case of twin gastros-chisis,stayed alive（ survival rate 100% ）. Of total 23 patients from complex group,8 patients gave up treatment,other 15 patients were performed two-stage repair,and 5 of them died because of severe perito-neal cavity infection and multiple organ failure（survival rate 66. 7% ）. Conclusion The death of these patients with one-stage repair was zero in our study. Early intervention of delivery room surgery is worth expanding. Silo bag plays an important role in two-stage gastroschisis repair.

关 键 词：腹裂 Ⅰ期修补手术 Silo袋 产房外科 

分 类 号：R726.5[医药卫生—儿科]