多学科联合诊疗先天性束带综合征  

Multidisciplinary team for the diagnosis and treatment of congenital band syndrome

作　　者：赵长应 张航 李玲霞 吕艳红 舒瑞 王煜 靳宏虎 丛锐 Zhao Changying;Zhang Hang;Li Lingxia;Lyu Yanhong;Shu Rui;Wang Yu;Jin Honghu;Cong Rui(Department of Orthopaedics,the First Affiliated Hospital of the Chinese People′s Liberation Army Air Force Military Medical University,Xi′an 710032,China;Department of Obstetrics and Gynecology,the First Affiliated Hospital of the Chinese People′s Liberation Army Air Force Military Medical University,Xi′an 710032,China;Department of Ultrasound,the First Affiliated Hospital of the Chinese People′s Liberation Army Air Force Military Medical University,Xi′an 710032,China;Department of Anesthesiology,the First Affiliated Hospital of the Chinese People′s Liberation Army Air Force Military Medical University,Xi′an 710032,China;Department of Digestive Surgery,Xi′an International Medical Center Hospital,Xi′an 710032,China)

机构地区：[1]中国人民解放军空军军医大学第一附属医院骨科,西安710032 [2]中国人民解放军空军军医大学第一附属医院妇产科,西安710032 [3]中国人民解放军空军军医大学第一附属医院超声科,西安710032 [4]中国人民解放军空军军医大学第一附属医院麻醉科,西安710032 [5]西安国际医学中心消化外科,西安710032

出　　处：《中华实用儿科临床杂志》2021年第20期1576-1578,共3页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的探讨多学科联合诊疗在先天性束带综合征中的意义。方法回顾性分析中国人民解放军空军军医大学第一附属医院2017年1月至2020年1月收治的5例先天性环形束带综合征患儿,从胎儿期起经妇产科、超声科、骨手外科等联合诊断并跟踪治疗。结果1例在胎儿期监测发现环形束带逐渐加重,影响患肢远端血液循环,及时在胎儿镜下予部分束带切除松解术;5例患儿在出生时均存在PattersonⅠ型环形束带,束带远端肢体无明显畸形,择期行环形束带切除术,术后均获得8~13个月的随访,平均随访时间10.6个月,皮肤环形凹陷均消失,外形及功能满意。参照Moses评分标准评定:优4例,良1例,优良率100%。结论先天性束带综合征的多学科联合诊疗可以最大程度地发挥各学科医师的专业优势,早诊断,早治疗,以最大程度地减轻环形束带对肢体的压迫,避免严重的肢体发育畸形,值得临床应用。Objective To explore the significance of multidisciplinary team for the diagnosis and treatment of congenital band syndrome.Methods Five children with congenital circular band syndrome admitted in the First Affiliated Hospital of the Chinese People′s Liberation Army Air Force Medical University from January 2017 to January 2020 were retrospectively analyzed.They were diagnosed,treated and followed up by a multidisciplinary team including the department of obstetrics and gynecology,ultrasound,and orthopedics from the fetal stage.Results One case was found with gradually aggravated ring band that affects the blood circulation of distal limbs during fetal examination,who was promptly performed with partial band release under fetoscopy.All cases had Patterson typeⅠring bands at birth,and distal limbs did not have obvious deformity.They were performed with selective annular band resection,and postoperatively followed up for an average of 10.6(8-13)months.The annular depression of the skin disappeared,and the appearance and function recovered satisfactory.According to the monitoring of side effects scale(Moses),4 cases were excellent,1 case was good,and the excellent and good rate was 100%.Conclusions The multidisciplinary team for the diagnosis and treatment of congenital band syndrome can maximize the professional advantages of physicians with diffe-rent specialties,make early diagnosis and treatment,minimize the compression of the ring band on the limbs,and avoid serious limb deformities.It is worthy of clinical application.

关 键 词：环形束带 先天性 多学科联合 手术治疗 

分 类 号：R726.5[医药卫生—儿科]