婴幼儿乳糜腹手术治疗:附11例报道  

Surgical Treatment of Chylous Ascites in Infants and Young Children:Report of 11 Cases

作　　者：王翔[1] 刘明坤 郑伟军 陈飞 吴典明 方一凡 WANG Xiang;LIU Mingkun;ZHENG Weijun;CHEN Fei;WU Dianming;FANG Yifan(Fujian Children's Hospital(Fujian Branch of Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine),Fujian Maternal and Child Health Care Hospital,College of Clinical Medical for Obstetrics&Gynecology and Pediatrics,Fujian Medical University,Fuzhou 350122,China)

机构地区：[1]福建省儿童医院(上海交通大学医学院附属上海儿童医学中心福建医院),福建省妇幼保健院,福建医科大学妇儿临床医学院,福州350122

出　　处：《福建医科大学学报》2023年第1期52-55,共4页Journal of Fujian Medical University

摘　　要：目的总结并分享婴幼儿乳糜腹的手术经验。方法回顾性分析2013年9月—2022年7月收治的11例手术治疗的乳糜腹患儿的临床资料。男婴8例,女婴3例;就诊年龄1(0.033,2)个月;产前彩超发现4例,出生后出现腹胀、呕吐症状7例。于肠系膜根部发现漏孔5例,给予缝合结扎,其中传统剖腹探查3例,使用纳米炭术中定位2例;肠旋转不良4例,予行Ladd手术;术中探查未见明显漏孔2例,予腹腔引流。结果11例患儿经手术治疗后皆治愈。随访3~6个月,无复发病例。结论婴幼儿乳糜腹保守治疗疗效不佳者可予手术治疗。术中探查发现漏孔者,予结扎后预后好。术中使用纳米炭定位可缩短手术时间。先天性肠旋转不良也是婴幼儿乳糜腹常见的病因,应积极探查复位,术后恢复好。Objective To summarize and share the surgical experience of chylous ascites in infants and young children.Methods The clinical data of 11 children with chylous ascites were retrospectively analyzed,including 8 males and 3 females,from September 2013 to July 2022 in Fujian Children's Hospital.The average age of treatment is 1(0.033,2)month;4 cases were detected by prenatal ultrasound,and 7 cases presented with abdominal distension and vomiting symptoms after birth.Five cases were found to have leaky holes in the root of the mesentery,which were sutured and ligated,including three cases of traditional dissection and two cases of intraoperative localization using nano charcoal;four cases of poor intestinal rotation were treated with Ladd surgery;two cases were found to have no obvious leakage holes during the operation,and abdominal drainage was given.Results All 11 children were cured after surgery.There were no recurrent cases at 3-6 months of follow-up.Conclusion Infants and young children with chylous ascites are routinely treated conservatively,but can be treated surgically when they do not respond well.The prognosis is good after ligation of the leaky hole found during intraoperative exploration.The use of nanocarbon localization can shorten the operation time and have a good effect.Congenital malrotation of intestine is also a common cause of chylous ascites in infants and young children,and should be actively explored and repositioned for good postoperative recovery.

关 键 词：乳糜腹 手术治疗 纳米炭 

分 类 号：R726.5[医药卫生—儿科]