CAJ | 학술논문

目的：探讨结肠闭锁的病因、分类、临床表现、外科治疗及预后。方法收集本院2004年10月至2013年10月收治的18例结肠闭锁患儿临床资料，总结我们在诊疗方面的经验。结果18例患儿中，外院造瘘1例，本院急诊手术17例，均在入院后8～20 h内手术。闭锁部位发生在横结肠8例，升结肠3例，降结肠2例，结肠肝曲2例，结肠脾曲2例，乙状结肠1例。Ⅲ型14例，Ⅰ型2例，Ⅱ型2例。14例行一期肠吻合术，3例行乙状结肠造瘘，1例术中放弃治疗。全组有2例死亡。结论当闭锁发生在近端结肠时应选择回结肠吻合；当闭锁盲端在脾区以远，可以保留回盲部及部分近端结肠行结结肠吻合；如果闭锁盲端超过乙状结肠或患儿一般情况较差时，应先行肠造瘘。
목적：탐토결장폐쇄적병인、분류、림상표현、외과치료급예후。방법수집본원2004년10월지2013년10월수치적18례결장폐쇄환인림상자료，총결아문재진료방면적경험。결과18례환인중，외원조루1례，본원급진수술17례，균재입원후8～20 h내수술。폐쇄부위발생재횡결장8례，승결장3례，강결장2례，결장간곡2례，결장비곡2례，을상결장1례。Ⅲ형14례，Ⅰ형2례，Ⅱ형2례。14례행일기장문합술，3례행을상결장조루，1례술중방기치료。전조유2례사망。결론당폐쇄발생재근단결장시응선택회결장문합；당폐쇄맹단재비구이원，가이보류회맹부급부분근단결장행결결장문합；여과폐쇄맹단초과을상결장혹환인일반정황교차시，응선행장조루。
Objetive To explore the etiology,classification,clinical manifestation,surgical treatment and prognosis of colonic atresia. Methods The medical data of patients between December 2004 to December 201 3 with colonic atresia were reviewed,and experience on treatment was summarized. Results All the 1 8 pa-tients underwent operation 8~20 hours after admission.Among which,1 7 received emergency operation in our hospital.Location of the atresia was in ascending colon (n=3),hepatic flexure (n=2),transverse colon (n=8),lower colon (n=2),spleenic flexure (n=2)and sigmoid colon (n=1 ).According to categories of the atresia,Ⅲ (n=14),Ⅰ(n=2),Ⅱ(n=2).14 cases received stage I anastomosis,3 Sigmoid colosto-my,and 1 gave up treatment.2 patients died. Conclusion When the the atresia is in the proximal colon,il-eo-colic anastomosis should be adopted.When the blind side of atresia is beyond the splenic flexure,the ileo-cecal valve and part of the proximal colon should be retained and colocolic anastomosis should be adopted. When the blind side of atresia is beyond the sigmoid colon or with poor general condition,enterostomy should be adopted.