CAJ | 학술논문

目的探讨胸腹连体儿分离手术成功后的内科治疗经验.方法分析一对胸腹连体女婴的临床表现和诊治经过.该胸腹连体女婴白胸部乳头水平上5 cm至脐部联体,合并复杂性先天性心脏病.于生后17 d行胸腹联体畸形分离术,术后A婴死亡,B女婴出现严重的心力衰竭、脓毒症、多脏器功能损害(肝脏、血液、肾脏)等并发症,除加强患儿生命体征的监护外,通过加强客观指标的检测,如血常规、C反应蛋白、肝功生化、血培养、痰培养、G试验和GM试验、血气分析、胸片等,早期发现和控制感染,及时了解患儿各脏器的功能状态,保护重要脏器功能.结论心血管畸形、呼吸衰竭、严重感染是胸腹连体儿分离术后常见的死亡原因；预防和控制感染、保护重要脏器功能至关重要；尽早纠治先天性心脏病可以提高患儿存活的可能性.
목적 탐토흉복련체인분리수술성공후적내과치료경험.방법 분석일대흉복련체녀영적림상표현화진치경과.해흉복련체녀영백흉부유두수평상5 cm지제부련체,합병복잡성선천성심장병.우생후17 d행흉복련체기형분리술,술후A영사망,B녀영출현엄중적심력쇠갈、농독증、다장기공능손해(간장、혈액、신장)등병발증,제가강환인생명체정적감호외,통과가강객관지표적검측,여혈상규、C반응단백、간공생화、혈배양、담배양、G시험화GM시험、혈기분석、흉편등,조기발현화공제감염,급시료해환인각장기적공능상태,보호중요장기공능.결론 심혈관기형、호흡쇠갈、엄중감염시흉복련체인분리술후상견적사망원인；예방화공제감염、보호중요장기공능지관중요；진조규치선천성심장병가이제고환인존활적가능성.
Objective To analyze and summarize the medical treatment experience following separation of thoracopagus conjoined twins.Method The clinical manifestations and the medical therapy of a pair of thoracopagus conjoined twins were analyzed. The conjunction of the female twins was from 5 cm above the nipple to the umbilicus.They also suffered from complex congenital heart diseases.At the 17th day of their lives,they were surgically separated.One girl died after the operation,the other survived but experienced heart failure,sepsis and multiple organ dysfunction ( including liver,blood and kidney et c.).In order to protect or maintain the main organ function,the vital signs and the objective indexes were monitored continually, such as blood routine test, C reactive protein, hepatorenal function, bacterial culture,and galactomannan test,blood gas analysis and chest radiogram.Conclusion It is important to protect the main organ function and prevent or control infection.The early surgical correction of congenital heart disease may contribute to recovery of the children.