11例巨大脐膨出合并肠旋转不良病例汇报及文献复习  

Report and literature review of 11 cases of giant omphalocele complicated with adverse intestinal rotation

作　　者：蒙绍旺 黄高杰 李永明 欧作强 黄名 李威汉 曾甜[1] MENG Shaowang;HUANG Gaojie;LI Yongming;OU Zuoqiang;HUANG Ming;LI Weihan;ZENG Tian(Department of Neonatal Surgery,Maternity and Child Health Care of Guangxi Zhuang Autonomous Region,Nanning,Guangxi,530000,China)

机构地区：[1]广西壮族自治区妇幼保健院新生儿外科,广西南宁530000

出　　处：《当代医学》2024年第19期1-5,共5页Contemporary Medicine

基　　金：广西儿科疾病临床医学研究中心(2021AC04002);广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190899)。

摘　　要：目的探讨巨大脐膨出合并肠旋转不良患儿的诊治经验。方法回顾性分析2016年7月至2023年7月广西壮族自治区妇幼保健院收治的11例巨大脐膨出合并肠旋转不良患儿的临床资料,并以脐膨出合并肠旋转不良为关键词,检索PubMed、Springer Link、Google Scholar、中国生物医学文献服务系统、中国知识基础设施工程(知网)、万方数据知识服务平台(万方)和中文科技期刊数据库(维普)等数据库,检索日期为建库至2023年6月30日。结果11例患儿均行Ⅰ期脐膨出修补术,其中未应用补片2例,其余9例需应用同种异体人脱细胞真皮补片修补,患儿平均体质量(3087.3±549.3)g,平均基部缺损直径(6.9±1.9)cm,平均手术时间(151.4±46.8)min,平均术后呼吸机治疗时间(5.2±2.9)d;1例患儿因粘连性肠梗阻再次手术松解粘连。通过文献检索,共纳入21篇文献,4114例脐膨出患儿,其中合并肠旋转不良188例,肠旋转不良在巨大脐膨出中占比21.3%,而在小型脐膨出中占比12.6%;5篇文献提及脐膨出合并肠旋转不良术后发生肠扭转情况,发生率为17.1%,3篇文献提及术后发生肠粘连情况,发生率为27.3%。结论对于脐膨出患儿术前排查及是否合并肠旋转不良是有必要性的,而进行Ladd’s术并未明显增加术后粘连性肠梗阻的发生率。Objective To explore the experience of diagnosis and treatment of giant omphalocele complicated with adverse intestinal rotation.Methods The clinical data of 11 children with giant omphalocele complicated with adverse intestinal rotation admitted to the Maternity and Child Health Care of Guangxi Zhuang Autonomous Region from July 2016 to July 2023 were retrospectively analyzed,PubMed,Springer Link,Google Scholar,China Biomedical Literature Service System,China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Plantporm(Wanfang)and Chinese Science and Technology Journal Database(VIP)were searched with giant omphalocele complicated with adverse intestinal malrotation as the Keywords,the search date was from the establishment of the database to June 30,2023.Results All of the 11 children underwentⅠstage repair of omphalocele,of which 2 cases did not use patch,and the remaining 9 cases needed human acellular dermal matrix,the average body mass of the children was(3087.3±549.3)g,and the average base defect diameter was(6.9±1.9)cm,the average operation time was(151.4±46.8)min,and the average postoperative ventilator treatment time was(5.2±2.9)d;1 childern underwent reoperation to release the adhesions due to adhesive ileus.Through literature search,a total of 21 literatures were included,and a total of 4114 children with giant omphalocele were analyzed,among which 188 cases were combined with adverse intestinal rotation,the proportion of adverse intestinal rotation was 21.3%in giant omphalocele and 12.6%in small omphalocele;the incidence of intestinal torsion after giant omphalocele combined with adverse intestinal rotation was mentioned in 5 literatures,and the incidence of intestinal torsion was 17.1%,the incidence of intestinal adhesion was mentioned in 3 literatures,and the incidence was 27.3%.Conclusion Preoperative screening of children with giant omphalocele and whether it is complicated with adverse intestinal rotation are necessary,however,Ladd’s surgery does not significantly incr

关 键 词：脐膨出 腹壁缺损 肠旋转不良 

分 类 号：R72[医药卫生—儿科]