新生儿先天性消化道畸形334例临床诊治分析  

Clinical diagnosis and treatment of 334 neonates with congenital digestive tract malformation

作　　者：杨冬 白瑞苗 罗立倩 李占魁 汪瑜 YANG Dong;BAI Ruimiao;LUO Liqian;LI Zhankui;WANG Yu(Neonatology Department,Northwest Women's and Children's Hospital,Xi'an 710061,China)

机构地区：[1]西北妇女儿童医院新生儿科,陕西西安710061

出　　处：《临床医学研究与实践》2023年第2期21-25,共5页Clinical Research and Practice

基　　金：陕西省重点研发计划项目(No.2021SF-195)。

摘　　要：目的 探讨不同类型新生儿先天性消化道畸形的临床表现及治疗情况,以提高该病的诊断治疗效果。方法 选取2015年1月1日至2019年8月31日在西北妇女儿童医院新生儿重症监护室住院治疗的334例先天性消化道畸形患儿作为研究对象。回顾性分析患儿的临床资料,分析不同畸形类型患儿的临床表现、产前诊断、手术治疗情况及预后。结果 新生儿先天性消化道畸形主要包括肛门闭锁、食道闭锁和食管气管瘘、先天性空肠或回肠闭锁、十二指肠闭锁或狭窄、肥厚性幽门狭窄、膈疝。肛门、食道、肠道闭锁等以呕吐、腹胀为主要临床表现,膈疝以呼吸费力、发绀为主要临床表现。产前B超检查对新生儿先天性消化道畸形的早期诊断具有重要意义,手术治疗为主要治疗方法。结论 临床应普及优生优育知识,夫妻双方妊娠期间改变吸烟、饮酒等不良生活习惯,加强产前咨询,正规产前检查,尽可能降低新生儿先天性消化道畸形发生率。新生儿出生后应早期识别、诊断先天性消化道畸形,及早转入专科医院进行手术治疗,进而改善预后,降低病死率。Objective To investigate the clinical manifestations and treatment of different types of neonatal congenital digestive tract malformation, so as to improve the diagnosis and treatment effect of the disease. Methods A total of 334 neonates with congenital digestive tract malformation hospitalized in the neonatal intensive care unit of Northwest Women’s and Children’s Hospital were selected as the study objects. The clinical data of the neonates were retrospectively analyzed,and the clinical manifestations, prenatal diagnosis, surgical treatment and prognosis of children with different malformation types were analyzed. Results Neonatal congenital digestive tract malformation mainly include anal atresia, esophageal atresia and esophagotracheal fistula, congenital jejunum or ileum atresia, duodenal atresia or stenosis, hypertrophic pyloric stenosis and diaphragmatic hernia. The main clinical manifestations of anal, esophageal and intestinal atresia were vomiting and abdominal distension, while the main clinical manifestations of diaphragmatic hernia were laborious breathing and cyanosis.Prenatal B ultrasound examination was of great significance for the early diagnosis of neonatal congenital gastrointestinal malformations, and surgical treatment was the main treatment. Conclusion The knowledge of give a good birth and good care should be popularized in clinical practice, and both husband and wife should change the bad living habits such as smoking and drinking during pregnancy, strengthen prenatal consultation and regular prenatal examination, so as to reduce the incidence of neonatal congenital digestive tract malformation as much as possible. After birth of neonates, it is necessary to early identify and diagnose the congenital digestive tract malformation, and transfer the children to a special hospital for surgical treatment as early as possible, so as to improve the prognosis and reduce the mortality.

关 键 词：先天性消化道畸形 新生儿 肛门闭锁 膈疝 

分 类 号：R726.5[医药卫生—儿科]