新生儿先天性胃壁肌层缺损致胃穿孔诊疗分析  

Diagnosis and treatment of neonatal gastric perforation caused by congenital gastric wall myometrial defect

作　　者：潘江[1] 刘小波 黄顺根[1] 汪健[1] PAN Jiang;LIU Xiao-bo;HUANG Shun-gen(Department of General Surgery,Children’s Hospital of Soochow University,Suzhou 215003,China)

机构地区：[1]苏州大学附属儿童医院普外科,215003

出　　处：《中国现代药物应用》2020年第21期7-9,共3页Chinese Journal of Modern Drug Application

摘　　要：目的探讨新生儿先天性胃壁肌层缺损致胃穿孔的临床特点及诊疗措施。方法回顾性分析13例先天性胃壁肌层缺损致胃穿孔新生儿的临床资料。结果13例均行手术治疗,包括常规开腹手术及腹腔镜微创手术,并经病理证实符合临床诊断。其中8例存活,5例放弃,术后短期随访,患儿生长发育良好。结论针对新生儿先天性胃壁肌层缺损致胃穿孔,根据临床表现,结合病史、体征及腹部立位X片大部分不难诊断,诊断明确或有相应手术指征应尽早进行手术探查,彻底切除病变及探查发现并同时完成合并消化道畸形矫正,结合有效抗感染、抗休克及呼吸、循环、营养支持可降低该病死亡率,获得良好治疗效果。Objective To discuss the clinical features and diagnosis and treatment measures of neonatal gastric perforation caused by congenital gastric wall myometrial defect.Methods The clinical data of 13 neonates with gastric perforation caused by congenital gastric wall myometrial defect were retrospectively analyzed.Results All 13 cases underwent surgical treatment,including conventional laparotomy and laparoscopic minimally invasive surgery,which were confirmed by pathology to meet clinical diagnosis.Among them,8 cases survived and 5 cases gave up.The children grew well after short-term follow-up.Conclusion According to clinical manifestations,medical history,physical signs and abdominal X-ray films,it is not difficult to diagnose gastric perforation caused by congenital gastric wall myometrial defect.If the diagnosis is clear or there are corresponding surgical indications,surgical exploration should be carried out as soon as possible,and the lesions should be completely removed and explored,and the combined digestive tract malformation correction should be completed at the same time.Combined with effective anti infection,anti shock and respiratory,circulatory and nutritional support can reduce the mortality of the disease and obtain good therapeutic effect.

关 键 词：先天性胃壁肌层缺损 穿孔 消化道畸形 幽门闭锁 

分 类 号：R726.5[医药卫生—儿科]