發(fā)布時(shí)間：2019-03-09 10:03

【摘要】：目的：總結(jié)六年來我科收治的43例先天性腸閉鎖的診斷方法、治療手段以及預(yù)后,為臨床先天性腸閉鎖的早期診斷、有效治療以及預(yù)后干預(yù)積累經(jīng)驗(yàn)。 方法：分析我院2007年1月至2012年12月收治的43例先天性腸閉鎖臨床資料,提取患兒的影像學(xué)圖像、手術(shù)治療方式結(jié)合文獻(xiàn)分析。對(duì)可能影響預(yù)后對(duì)8個(gè)因素,使用logistic非線性回歸和卡方檢驗(yàn)對(duì)預(yù)后進(jìn)行分析。 結(jié)果：腹部平片對(duì)腸閉鎖可以得出腸梗阻的初步診斷,符合率為100%。上消化道造影可以明確診斷為腸閉鎖,本組資料診斷符合率均為100%。手術(shù)方式以腸切除腸吻合為主(32例)。影響預(yù)后因素有：1.出生體重越輕預(yù)后越差(P=0.049)。BG(出生體重)2500g時(shí)治愈率為78.3%,BG2500g時(shí)僅為40%(P=0.028)。2.術(shù)前合并肺部感染也是影響先天性腸閉鎖預(yù)后等重要因素(P=0.033)。術(shù)前合并肺部感染的治愈率為36.4%,術(shù)前未合并肺部感染的治愈率81.2%(P=0.009)。3.有無合并其他畸形對(duì)先天性腸閉鎖也有統(tǒng)計(jì)學(xué)意義(P=0.031)。合并其他畸形的先天性腸閉鎖治愈率為45.5%,未合并其他畸形治愈率為78.2%(P=0.042)。 結(jié)論：1.腹部平片、消化道造影對(duì)先天性腸閉鎖診斷均具有意義。合理的術(shù)式選擇和細(xì)致圍手術(shù)期處理可以提高先天性腸閉鎖的生存率。2.低體重、術(shù)前合并肺部感染、合并畸形和Ⅲ型、Ⅳ型病理分型是影響先天性腸閉鎖預(yù)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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