43例先天性肠闭锁的临床诊疗总结

发布时间：2019-03-09 10:03

【摘要】：目的：总结六年来我科收治的43例先天性肠闭锁的诊断方法、治疗手段以及预后,为临床先天性肠闭锁的早期诊断、有效治疗以及预后干预积累经验。 方法：分析我院2007年1月至2012年12月收治的43例先天性肠闭锁临床资料,提取患儿的影像学图像、手术治疗方式结合文献分析。对可能影响预后对8个因素,使用logistic非线性回归和卡方检验对预后进行分析。 结果：腹部平片对肠闭锁可以得出肠梗阻的初步诊断,符合率为100%。上消化道造影可以明确诊断为肠闭锁,本组资料诊断符合率均为100%。手术方式以肠切除肠吻合为主(32例)。影响预后因素有：1.出生体重越轻预后越差(P=0.049)。BG(出生体重)2500g时治愈率为78.3%,BG2500g时仅为40%(P=0.028)。2.术前合并肺部感染也是影响先天性肠闭锁预后等重要因素(P=0.033)。术前合并肺部感染的治愈率为36.4%,术前未合并肺部感染的治愈率81.2%(P=0.009)。3.有无合并其他畸形对先天性肠闭锁也有统计学意义(P=0.031)。合并其他畸形的先天性肠闭锁治愈率为45.5%,未合并其他畸形治愈率为78.2%(P=0.042)。 结论：1.腹部平片、消化道造影对先天性肠闭锁诊断均具有意义。合理的术式选择和细致围手术期处理可以提高先天性肠闭锁的生存率。2.低体重、术前合并肺部感染、合并畸形和Ⅲ型、Ⅳ型病理分型是影响先天性肠闭锁预后的主要因素。
[Abstract]:Aim: to summarize the diagnostic methods, treatment methods and prognosis of 43 cases of congenital intestinal atresia admitted in our department in the past six years, and to accumulate experience for early diagnosis, effective treatment and prognosis intervention of clinical congenital atresia. Methods: the clinical data of 43 cases of congenital intestinal atresia admitted to our hospital from January 2007 to December 2012 were analyzed. Logistic non-linear regression and chi-square test were used to analyze the prognosis of 8 factors which might affect the prognosis. Results: the initial diagnosis of intestinal obstruction can be obtained by abdominal plain film, the coincidence rate is 100%. Upper alimentary tract angiography can clearly diagnose intestinal atresia, and the coincidence rate of these data is 100%. The main operative method was intestinal resection and anastomosis (32 cases). The prognostic factors are: 1. The poorer the birth weight was, the worse the prognosis was (P = 0.049). The cure rate of BG (birth weight) was 78.3% at 2500g and 40% at BG2500g (P < 0.028). Preoperative pulmonary infection is also an important factor affecting the prognosis of congenital atresia (P0. 033). The cure rate of preoperative pulmonary infection was 36.4%, and that of non-pulmonary infection was 81.2% (P < 0.009). There was also statistical significance for congenital atresia with or without other malformations (P < 0. 031). The cure rate of congenital intestinal atresia with other malformations was 45.5%, and that without other malformations was 78.2% (P < 0.042). Conclusion: 1. Abdominal plain film and alimentary tract angiography are of significance in the diagnosis of congenital intestinal atresia. Reasonable choice of operation and careful perioperative management can improve the survival rate of congenital intestinal atresia. 2. Low body weight, preoperative pulmonary infection, malformation and type 鈪，

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