CAJ | 학술논문

目的:观察小肠重复肠管的血运与相应主肠管的血运之间的关系,探讨单纯切除重复肠管的可行性.方法:对78例患儿的81个小肠重复畸形肠管进行观察,男53例,女25例,平均年龄2.9岁.结果:根据重复肠管的血运可将肠重复畸形分为两型:并列型(Ⅰ型)和系膜内型(Ⅱ型).81例重复肠管中,Ⅰ型61例(75.3%),以囊肿形居多,Ⅰ型20例(24.7%),以管状为多.Ⅱ型91.6%合并胸椎椎体畸形,而Ⅰ型仅6.2%合并胸椎畸形.2年来对14例患儿行单纯切除重复肠管而保留主肠管的手术,其中Ⅰ型11例,Ⅱ型3例,术中分别离断重复肠管的直动脉和直动脉的短支,切除重复肠管,主肠管的血运未受影响.术后随访无肠狭窄及梗阻发生.结论:小肠重复畸形可分为并列型和系膜内型,后者可能因胚胎早期脊柱原肠分离障碍所致.重复肠管有相对独立的血运,单纯切除之,主肠管的血运不受影响.
목적:관찰소장중복장관적혈운여상응주장관적혈운지간적관계,탐토단순절제중복장관적가행성.방법:대78례환인적81개소장중복기형장관진행관찰,남53례,녀25례,평균년령2.9세.결과:근거중복장관적혈운가장장중복기형분위량형:병렬형(Ⅰ형)화계막내형(Ⅱ형).81례중복장관중,Ⅰ형61례(75.3%),이낭종형거다,Ⅰ형20례(24.7%),이관상위다.Ⅱ형91.6%합병흉추추체기형,이Ⅰ형부6.2%합병흉추기형.2년래대14례환인행단순절제중복장관이보류주장관적수술,기중Ⅰ형11례,Ⅱ형3례,술중분별리단중복장관적직동맥화직동맥적단지,절제중복장관,주장관적혈운미수영향.술후수방무장협착급경조발생.결론:소장중복기형가분위병렬형화계막내형,후자가능인배태조기척주원장분리장애소치.중복장관유상대독립적혈운,단순절제지,주장관적혈운불수영향.
Objective:To investigate the vascular supply of intestinal duplication and introduce a new operative procedure to preserve a normal intestine.Methods:From 1972 to 1996,78 patients with intestinal duplication were treated surgically,and 14 underwent resection of the duplication without the adjacent intestine.Results:The duplications,by our way of division according to the blood supply,were parallel type(type Ⅰ,75.3%)and intramesenteric type(type Ⅱ,24.7%).Both types containing seperate blood supply to the adjacent normal intestine enabling a resection of the duplication without the normal intestine.Fourteen cases(type Ⅰ11,typeⅡ3)were treated by this method and followed-up for 4 years with satisfactory results. Conclusions:Most intestinal duplications have separable vascular supply. Complete resection of the duplication with preservation of normal adjacent intestine is a satisfactory operative procedure