CAJ | 학술논문

目的总结先天性肠闭锁的部位、病理分型的发生率，分析影响肠闭锁预后因素。方法回顾性分析本院自2002年12月至2012年12月收治的113例先天性肠闭锁患儿临床资料，对其死亡率、术后肠梗阻发生率、术后排便时间及进食时间进行统计学分析。结果肠闭锁部位为十二指肠26例（23．0％），空肠30例（26．5％），回肠53例（47．0％），结肠4例（3．5％）。按 Grosfeld 病理分型标准：Ⅰ型42例（37．2％），Ⅱ型18例（15．9％），Ⅲa 型27例（23．9％），Ⅲb 型7例（6．2％），Ⅳ型19例（16.8％）。死亡率与术后肠梗阻的发生有统计学意义（P ＜0．05），术后肠梗阻的发生率与闭锁部位、闭锁类型相关（P ＜0．05），与肠吻合方式无明显相关（P ＞0．05），术后排便及进食时间与肠闭锁部位有关（P ＜0．05）。结论随着新生儿监护治疗技术的发展，先天性肠闭锁的死亡率逐步下降，肠闭锁的部位、病理分型、术后并发症（肠梗阻、短肠综合征）、合并严重的畸形是影响其预后的重要因素。
목적총결선천성장폐쇄적부위、병리분형적발생솔，분석영향장폐쇄예후인소。방법회고성분석본원자2002년12월지2012년12월수치적113례선천성장폐쇄환인림상자료，대기사망솔、술후장경조발생솔、술후배편시간급진식시간진행통계학분석。결과장폐쇄부위위십이지장26례（23．0％），공장30례（26．5％），회장53례（47．0％），결장4례（3．5％）。안 Grosfeld 병리분형표준：Ⅰ형42례（37．2％），Ⅱ형18례（15．9％），Ⅲa 형27례（23．9％），Ⅲb 형7례（6．2％），Ⅳ형19례（16.8％）。사망솔여술후장경조적발생유통계학의의（P ＜0．05），술후장경조적발생솔여폐쇄부위、폐쇄류형상관（P ＜0．05），여장문합방식무명현상관（P ＞0．05），술후배편급진식시간여장폐쇄부위유관（P ＜0．05）。결론수착신생인감호치료기술적발전，선천성장폐쇄적사망솔축보하강，장폐쇄적부위、병리분형、술후병발증（장경조、단장종합정）、합병엄중적기형시영향기예후적중요인소。
Objective To conclude the position and ratio of each pathological type of the congenital in-testinal atresia,and analyse the factors that affect prognosis of the intestinal atresia.Methods A retrospective analysis was made on the 113 patients with congenital intestinal atresia treated in our hospital from Dec 2002 to Dec 2012.A statistical analysis was conducted on the mortality,the rate of intestinal obstruction after the sur-gery,time for defecating and dieting.Results Intestinal atresia occurred in duodenum in 26 cases (23%), jejunum in 30 cases (26.5%),ileum in 53 cases (47%)and colon in 4 cases (3.5%).The pathological types were classified according to Grosfeld system:42 cases are of type Ⅰ (37.2%),18 of type Ⅱ(15.9%), 27 of type IIIa (23.9%),7 of type Ⅲb (6.2%)and 19 of type Ⅳ (16.8%).Statistical significance was found in mortality and intestinal atresia after surgery (P <0.05).The rate of intestinal atresia after surgery was related to the position and pathological type of the congenital intestinal atresia (P <0.05),but was not related to the intestinal anastomosis method (P >0.05).The time for defecating and dieting was related to the position after the surgery (P <0.05). Conclusion With the development of the neonate monitoring and therapy tech-nology,the mortality of congenital intestinal atresia got decreased gradually.The influencing factors affect prog-nosis were the position and pathological type of the congenital intestinal atresia,complication after surgery (in-testinal obstruction,short bowel syndrome)and associated serious malformation.