高原地区先天性食管闭锁9例临床分析  

Clinical Analysis of 9 Cases of Congenital Esophageal Atresia in High Altitude Areas

作　　者：曹小丽 玉珍 强巴措珍 松措 CAO Xiaoli;YU Zhen;QIANGBA Cuozhen;SONG Cuo(Department of Neonatology,Lhasa People's Hospital,Lhasa 850000,China)

机构地区：[1]拉萨市人民医院新生儿科,拉萨850000

出　　处：《中国医药指南》2024年第27期94-96,共3页Guide of China Medicine

摘　　要：目的通过解析我院收治的先天性食管闭锁9例患儿,讨论先天性食管闭锁的病因、治疗及疾病转归情况。方法对2021年4月至2023年4月我院新生儿科收治的9例先天性食管闭锁患儿的临床资料进行回顾性分析。分析患儿预后影响因素,对比患儿手术年龄、体重、手术时间、术后低蛋白血症、胸腔积液、气胸、吻合口瘘、肺炎加重等。结果9例患儿中,手术成功5例吻合口均无狭窄,总住院时间18~47 d,平均(31.20±11.19)d后治愈出院,4例放弃治疗(其中3例放弃手术治疗,1例为术后出现大量气胸而放弃治疗)。6例进行手术治疗患儿为Ⅲ型食管闭锁,均行食管吻合术+食管气管瘘结扎术,患儿术后均出现低蛋白血症,住院期间全静脉营养时间为9~28 d,平均(16.80±7.83)d,有创呼吸机撤机时间为6~22 d,平均(11.60±5.89)d。结论早发现、早诊断、早手术,术后加强各管道护理,保持呼吸道通畅,加强营养,呼吸机支持呼吸,应用合适抗生素,维持水电解质和酸碱平衡均十分重要,术后NICU精心监护且及时防治并发症对食管闭锁手术成功有重要意义。Objective Analysis of 9 cases of congenital esophageal atresia admitted to our hospital,discuss the etiology,treatment and disease outcome of congenital esophageal atresia.Methods A retrospective analysis was conducted on the clinical data of 9 children with congenital esophageal atresia admitted to the neonatal department of Lhasa People's Hospital from April 2021 to April 2023.Analyze the factors affecting the prognosis of the patient,compare the age,weight,duration of surgery,postoperative hypoproteinemia,pleural effusion,pneumothorax,anastomotic fistula and worsening of pneumonia in the affected children.Results Among the 9 pediatric patients,5 cases underwent successful surgery and all had no stenosis at the anastomotic site,the total hospitalization time is 18-47 days,after an average of(31.20±11.19)days of recovery and discharge,4 cases abandoned treatment(including 3 cases who abandoned surgical treatment and 1 case who abandoned treatment due to a large amount of pneumothorax after surgery).Six children who underwent surgical treatment were diagnosed with type III esophageal atresia,all patients underwent esophageal anastomosis and esophagotracheal fistula ligation,all patients developed hypoalbuminemia after surgery,the total intravenous nutrition time during hospitalization is 9-28 days,with an average of(16.80±7.83)days,and the withdrawal time of the invasive ventilator is 6-22 days,with an average of(11.60±5.89)days.Conclusions Early detection,diagnosis,and surgery,strengthen postoperative care for various pipelines,maintain airway patency,strengthen nutrition,the ventilator supports breathing,apply appropriate antibiotics,maintaining both water electrolyte and acid-base balance is crucial,careful postoperative NICU monitoring and timely prevention and treatment of complications are of great significance for the success of esophageal atresia surgery.

关 键 词：先天性食管闭锁 并发症 治疗 预后 

分 类 号：R726.5[医药卫生—儿科]