儿童梅克尔憩室出血的病因和治疗  

The pathogeny and treatment of Meckel's diverticulum bleeding in children

作　　者：黄茂华[1] 周欣[1] 魏文琼[1] 汤凤萍[1] 马春秋[1] 鲁建生[2] 

机构地区：[1]武汉市儿童医院外科,武汉430016 [2]武汉市儿童医院病理科,武汉430016

出　　处：《实用儿科临床杂志》2003年第11期920-921,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的　探讨梅克尔憩室出血的病因及外科治疗。方法　回顾性分析我院 1995年 1月～ 2 0 0 3年 1月收治 19例梅克尔憩室出血的临床资料。结果　剖腹手术 5例 ,其中行憩室楔状切除术 2例 ,憩室、肠切除术3例 ;腹腔镜下憩室切除术 14例 ,其中腹腔内憩室切除术 10例 ,腹腔镜辅助下腹腔外切除术 4例。血抗幽门螺杆菌 (Hp)抗体检查 5例 ,均阴性。憩室内均检出异位胃黏膜。溃疡、出血部位在憩室内小肠黏膜处 12例 ,异位胃黏膜处 2例 ,术后均痊愈。结论　憩室出血因异位胃黏膜所致 ,与Hp感染无关 ;溃疡、出血部位多在憩室内小肠黏膜处 ;腹腔镜手术或开腹手术应根据憩室形态。Objective To investigate the pathogeny and treatment of Meckel′s diverticulum bleeding in children.Methods A retrospective analysis was made on 19 children with Meckel′s diverticulum bleeding between January 1995 to January 2003.Results Five cases were treatmented with open approach resection of Meckel′s diverticulum.Fourteen cases were treatmented with laparoscopic assisted resection of Meckel′s diverticulum.Five cases studied with antibodies specific for Helicobacter pylori were negative.All had ectopic gastric mucosa in their diverticulum.The site of ulcreation was located at the ileal mucosa in the diverticulum for 12 patients and at the ectopic gastric mucosa for 2 cases.Conclusions Meckel′s diverticulum bleeding is caused by ectopic gastric mucosa,not by infection of Helicobacter pylori.The site of ulcreation most often is located at the normal ileal mucosa in the diverticulum.Whether a laparoscopic or open approach is used,the importance of extemal appearance of diverticulum orpalpation to identify the location of ectopic gastric mucosa and ulceration should be emphasized.

关 键 词：儿童 梅克尔憩室 异位胃黏膜 腹腔镜手术 

分 类 号：R726.5[医药卫生—儿科]