新生儿十二指肠梗阻32例临床分析  

Clinical analysis of 32 cases of neonatal duodenal obstruction

作　　者：冯运红[1] 

机构地区：[1]珠海市妇幼保健院小儿外科,519000

出　　处：《中国实用医药》2017年第22期32-34,共3页China Practical Medicine

摘　　要：目的探讨新生儿先天性十二指肠梗阻的病例特点、诊断要点及治疗方法选择。方法回顾性研究32例新生儿先天性十二指肠梗阻患儿的临床资料,就出生情况、发病时间、临床表现、影像学检查、手术方法、术后并发症及预后等方面进行分析。所有患儿均手术治疗,手术方式根据病理类型不同分别行隔膜切除、纵切横缝术,菱形吻合术,Ladd术。观察手术效果。结果 4例患儿术后出现切口感染,经切口换药愈合;2例行菱形吻合术患儿术后出现吻合口瘘,保守治疗后恢复顺利;全组患儿均随访3个月~3年,2例远期出现粘连性肠梗阻,经禁食、胃肠减压、补液等保守治疗痊愈。结论新生儿先天性十二指肠梗阻病因复杂,早期诊断与及时治疗是改善预后的关键,术中应考虑到并存和伴发其他消化道畸形的可能,应仔细检查,尽可能一次手术处理。Objective To investigate the case characteristics,diagnostic points and treatment options of neonatal duodenal obstruction.Methods Clinical date of 32 cases of neonatal duodenal obstruction was retrospectively studied,and analysis were made on birth condition,onset time,clinical manifestation,imaging examination,surgical method,postoperative complications and prognosis.All children were treated with operations,including membrane resection,longitudinal transverse surgery,rhombus anastomosis,Ladd surgery,and their surgical methods were decided according to difterent incision types.Their surgical effect was observed.Results Wound infection occurred in 4 cases and healed by incision dressing change.Anastomotic fistula occurred in 2 cases after rhomboid anastomosis and recovered smoothly after conservative treatment.All children were followed-up for 3 months～3 years,and 2 cases had long-term adhesive ileus,and they were cured by conservative treatment,including fasting,gastrointestinal decompression and fluid replacement.Conclusion Congenital duodenal obstruction has complicated etiology,early diagnosis and timely treatment are the key to improve the prognosis.The possibility of coexisting and accompanied with other digestive tract malformation should be considered during operation,should be carefully examined,as a surgical treatment.Patients should be carefully examined and handled with one operation as soon as possible.

关 键 词：十二指肠梗阻 新生儿 外科吻合术 

分 类 号：R722.1[医药卫生—儿科]