CAJ | 학술논문

为了了解先天性肠闭锁临床、病理、治疗、预后及其相互关系,对52例经手术证实的肠闭锁患儿进行回顾性分析.53%患儿有胆汁样呕吐,7例生后48小时有少量胎粪排出.闭锁部位:空肠9例,回肠37例,结肠5例,全肠道闭锁1例.闭锁类型:隔膜型6例,盲袋型30例,多发型13例,Apple-peel型3例.42.3%患儿合并胎粪性腹膜炎或肠扭转.52例均行手术治疗,治愈40例,治愈率76.92%.肠造瘘疗效差.裁剪式吻合治愈率为88.46%,肠切除吻合术治愈率为68.75%.出现症状时间与闭锁部位有关,强调对闭锁近端扩张肠段切除和裁剪吻合.就诊及治疗时间、腹腔严重合并症、术后并发症、再次手术、肠管保留长度及回盲瓣保存与否均是影响生存的重要因素.
위료료해선천성장폐쇄림상、병리、치료、예후급기상호관계,대52례경수술증실적장폐쇄환인진행회고성분석.53%환인유담즙양구토,7례생후48소시유소량태분배출.폐쇄부위:공장9례,회장37례,결장5례,전장도폐쇄1례.폐쇄류형:격막형6례,맹대형30례,다발형13례,Apple-peel형3례.42.3%환인합병태분성복막염혹장뉴전.52례균행수술치료,치유40례,치유솔76.92%.장조루료효차.재전식문합치유솔위88.46%,장절제문합술치유솔위68.75%.출현증상시간여폐쇄부위유관,강조대폐쇄근단확장장단절제화재전문합.취진급치료시간、복강엄중합병증、술후병발증、재차수술、장관보류장도급회맹판보존여부균시영향생존적중요인소.
Fifty-two infants with intestinal atresia are reviewed.Bile-stained vomiting was the first symptom (53%),and delayed meconium in 7 cases.The atresia located in jejunum (9),ileum (37),colon(5) and scattered all over the digestive tract in one case.The type of the atresia included:type Ⅰ (membranous) in 6 cases,type Ⅱ(blind end) 30,type Ⅲ (multiple) 13,and type Ⅳ (Apple-peel) 3.Associated volvulus and meconium peritonitis were found in 42.3%.Total survival rate of this series was 76.92%.The outcome of enterostomy was poor.Twenty-six cases were operated on by tapering of the proximal loop and end to end anastomosis with a survival rate of 88.45%,while the survival rate to those by simple resection and anastomosis was 68.75%.It is essential to resect and taper the proximal dilated blind loop and make an end to end anastomosis.Timing of operation,associated malformations,operative complications,reoperations,and length of the residual intestine are the important factors in prognosis.