258例儿童先天性十二指肠梗阻病例的回顾性分析

发布时间：2018-11-27 13:18

【摘要】：目的:收集258例先天性十二指肠梗阻的病例资料，分析并总结该病在儿童不同年龄段的临床特点和诊治要点。方法:收集我院2003年到2012年间收治的258例先天性十二指肠梗阻病例，对临床病例资料进行分组回顾性分析，，总结临床特点及诊治要点。结果：（1）先天性十二指肠梗阻多在新生儿期发病(X2=10.6583，P=0.0048)；（2）胆汁性呕吐（76.36%）是本病最突出的临床症状(X2=37.4821，P＜0.0001)；（3）腹部平片、腹部超声多普勒及上消化道造影对本组病例的阳性发现率分别为78.57%、73.71%和100%，有显著性差异（X2=51.3660,P＜0.0001）；（4）先天性肠旋转不良、十二指肠闭锁或狭窄、环状胰腺是先天性十二指肠梗阻最常见的病因；先天性十二指肠梗阻一经确诊，应尽早手术，预后好(本组治愈96.88%)。结论:生后出现胆汁性呕吐的患儿应首先考虑先天性十二指肠梗阻可能，及早行上消化道造影检查及腹部多普勒超声检查尽可能明确病因，但十二指肠梗阻诊断成立应尽早手术，预后多较好。
[Abstract]:Objective: to collect data of 258 cases of congenital duodenal obstruction, and to analyze and summarize the clinical features, diagnosis and treatment of congenital duodenal obstruction in different ages of children. Methods: 258 cases of congenital duodenal obstruction from 2003 to 2012 were collected and analyzed retrospectively. Results: (1) Bile vomiting (76.36%) was the most prominent clinical symptom of congenital duodenal obstruction in neonatal stage (X _ 2o _ (10.6583) P _ (0.0048); (_ 2) (P < 0.0001). (3) the positive rate of abdominal plain film, abdominal ultrasound Doppler and upper digestive tract angiography were 78.57% and 100%, respectively. There was significant difference between them (X2, 51.3660, P < 0.0001). (4) congenital intestinal malrotation, duodenal atresia or stenosis, annular pancreas were the most common etiology of congenital duodenal obstruction. Conclusion: children with bile vomiting after birth should first consider the possibility of congenital duodenal obstruction and make the upper gastrointestinal angiography and abdominal Doppler ultrasound as clear as possible. But the diagnosis of duodenal obstruction should be operated as soon as possible and the prognosis is better.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R726.5

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