新生儿先天性消化道畸形的临床特点及诊治分析  

Clinical characteristics and diagnosis and treatment analysis of congenital digestive tract malformations in newborns

作　　者：杨怡 谢承 林立华 黄圣余 Yang Yi;Xie Cheng;Lin Lihua(General Surgery Department,Children’s Hospital Branch of Fuzhou First General Hospital,Fuzhou 350000)

机构地区：[1]福州市第一总医院儿童专科院区福建省福州儿童医院普通外科,福建福州350000

出　　处：《中国现代医药杂志》2023年第12期15-19,共5页Modern Medicine Journal of China

摘　　要：目的探讨各类常见新生儿先天性消化道畸形的主要临床表现和诊治情况,以提高消化道畸形早期诊断率及准确率。方法回顾性分析我院2016年3月1日~2023年7月31日治疗的外科消化道疾病相关患儿,对其一般情况、临床表现、影像学资料、诊断及治疗情况等临床资料进行统计分析。结果本研究共收集到资料完整患儿274例,经过筛选173例患儿符合先天性消化道畸形诊断,包括肛门直肠畸形(42例)、先天性巨结肠(29例)、肠旋转不良(23例)、肠闭锁(16例)、先天性肥厚性幽门狭窄(12例)、食管闭锁(10例),先天性膈疝(7例)、先天性胃壁肌层缺损(6例)及其他疾病共19种。消化道畸形患儿诊断日龄统计结果显示,56.65%患儿在生后3日内确诊,临床主要表现为呕吐、腹胀、腹壁静脉显露、胎便异常、黄疸。产前超声诊断消化道畸形阳性率为8.67%,腹部X线平片的诊断阳性率为80.92%,腹部彩超诊断阳性率为76.88%。结论新生儿消化道畸形的临床表现各有特点,主要表现为呕吐、腹胀、腹壁静脉显露、排便异常等,而产前诊断的发现率较低,建议对有上述症状的患儿及早安排腹部X线检查及腹部彩超检查。Objective To explore the clinical characteristics,diagnosis and treatment of common neonatal congenital digestive track malformations,and promote the early diagnosis rate and accuracy of digestive track malformations.Methods A retrospective analysis was performed on the clinical data of patients with surgical digestive tract diseases who were hospitalized in our hospital from Mar 1,2016 to Jul 31,2023.The general condition,clinical characteristics,imaging data,diagnosis and treatment were analyzed.Results A total of 274 cases with complete data were collected in this study.After screening,173 cases met the diagnosis of congenital digestive tract malformation,including anorectal malformation(42 cases),Hirschsprung's disease(29 cases),intestinal malrotation(23 cases),intestinal atresia(16 cases),congenital hypertrophic pyloric stenosis(12 cases),esophageal atresia(10 cases),congenital diaphragmatic hernia(7 cases),congenital gastric wall muscular defect(6 cases)and other diseases,there were 19 kinds of diseases in all.56.65%of the infants were diagnosed within 3 days after birth.The main clinical manifestations were vomiting,abdominal distension,abdominal vein exposure,abnormal defecation and jaundice.The positive rate of prenatal ultrasound in the diagnosis of digestiue tract malformations was 8.67%,the positive rate of abdominal X-ray examination was 80.92%,and the positive rate of abdominal color Doppler ultrasound examination was 76.88%.Conclusion The clinical manifestations of neonatal digestive tract malformations have their own characteristics.The main manifestations are vomiting,abdominal distension,abdominal vein exposure,abnormal defecation.The detection rate of prenatal diagnosis is low.Children with the above symptoms should be early arranged the abdominal X-ray examination and the abdominal color ultrasound examination.

关 键 词：新生儿 消化道畸形 临床表现 诊断 

分 类 号：R722.1[医药卫生—儿科]